成人症状性骶管囊肿的外科治疗  

Surgical treatment of symptomatic sacral cyst in adults

作　　者：张绍辉[1] 尚爱加[2] 高超[1] 丁平[1] 崔建飞[1] 梁树立[1] 

机构地区：[1]解放军总医院第一附属医院神经外科,北京100048 [2]解放军总医院神经外科,北京100853

出　　处：《中国临床神经外科杂志》2016年第11期676-678,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 探讨成人症状性骶管囊肿的治疗方法及疗效。方法 2013年1月至2015年4月收治症状性骶管囊肿32例,均在术中监护下手术,采取囊壁大部分切除＋漏口缩窄＋自体脂肪瓣填塞术17例,囊壁切除＋交通孔缝扎＋自体脂肪瓣填塞术8例,囊壁部分切除＋神经袖套重建＋自体脂肪瓣填塞术7例。采用Oswestry功能障碍指数及改良腰椎日本骨科协会（JOA）评分评估手术前后功能状态及疼痛程度。结果 术后随访12～36个月,平均22个月,无复发;29例症状改善,功能恢复良好,术后1年Oswestry功能障碍指数及改良腰椎JOA评分均较术前明显改善（P〈0.01）。结论 依据骶管囊肿的分型,采取相应手术,可缓解患者疼痛及改善患者生活质量。Objective To discuss the strategies and outcomes of surgery for symptomatic sacral cysts in the adults. Methods Of 32 adult patients with symptomatic sacral cysts, 17 were treated by the resection of partial cysts wails ＋ fistula constriction ＋ filling with autologous fat tissues, 8 by resection of the total cysts walls＋ ligation of fistula ＋ filling with autologous fat tissues, and 7 by resection of partial cysts walls ＋ rebuilding of nerve sheath ＋ filling with autologous fat tissues according to the classification of sacral cyst from 2013 to 2015. The sacral nerve function and pain were assessed respectively by Oswestry dysfunction index （ODI） and modified Japanese Orthopedic Association （JOA） score in all the patients before and after the operation. Results Following up from 12 to 36 months （mean, 22 months） showed that no sacral cysts recurred in all the patients. The clinical symptoms were relived and the sacral nerve function was improved in 29 patients. ODI was significantly higher and JOA scores were significantly lower 1 year after the operation than those before the operation （P〈0.01）. Conclusions Rational surgical treatment according to the classification of sacral cyst can relieve pain and improve life quality in adults patients.

关 键 词：症状性骶管囊肿 Tarlov囊肿 成人 手术治疗 疗效 

分 类 号：R739.42[医药卫生—肿瘤] R651.11[医药卫生—临床医学]