腰骶神经根囊肿的临床诊断和治疗探讨  

Clinical Diagnosis and Treatment of Lumbosacral Spinal Cord Nerve Root Cysts

作　　者：王文跃[1] 倪斌[2] 陈顺方[1] 周海平[1] 冯健[1] 胡祖愉 王俭[1] 

机构地区：[1]浙江省海盐县人民医院骨科,314300 [2]第二军医大学附属长征医院骨科,上海市200003

出　　处：《中国矫形外科杂志》2003年第15期1023-1025,共3页Orthopedic Journal of China

摘　　要：目的:探讨腰骶神经根囊肿的临床诊断及治疗方法。方法:27例神经根囊肿患者,男17例,女10例,年龄42～65岁,平均53.6岁。其中有7例保守治疗,20例行手术治疗。手术中13例行囊肿大部分切除,残余部分缝合包绕囊内神经根;7例行囊肿大部分切除后用骶棘肌填塞交通孔。并对腰骶神经根囊肿的临床表现以及CT、脊髓造影、MRI等影像学资料进行分析。结果:CT扫描可见椎体后缘凹陷性压迹9例。脊髓造影显示神经根有囊状充盈11例。MRI显示囊肿在T_1加权像呈低信号,T_2加权像呈高信号,信号与脑脊液一致。结论:MRI对本病诊断和鉴别诊断具有重要的临床价值;对保守治疗无效者,应行椎板开窗减压和囊肿摘除术。Objective: To study the method of clinical diagnosis and treatment on lumbosacral spinal cord nerve root cysts. Method: There were 27 cases of lumbosacral spinal cord nerve root cysts, male 17, female 10, The average age were 53.6. Seven out of 27 cases adopted conservative treatment, 20 cases of which adopted operation. Thirteen out of 20 operative cases received resection of most parts of cysts, then the nerve root encyst in the rest cysts. Seven out of 20 operative cases received resection of most parts of cysts and plugging communicative hole with sacrospinous muscle. This thesis analyzed the data of clinical expressions ,CT scan, myelography and MRI. Result: CT scan find some incision on posterior border of vertebral body in 9 cases. Myelography showed that the cysts were full filled in 11 cases. MRI showed the cysts low signal on T1-weighted images and high signal on T2-weighted imges, similar to CSF. Conclusion: MRI plays a very important role in the diagnosis of lumbosacral spinal cord nerve root cysts. The operation need to be done if the conservative treatment is not effective.

关 键 词：腰骶 神经根 囊肿 治疗 

分 类 号：R651.3[医药卫生—外科学]