背侧单纯性脊膜膨出与脊髓栓系

作者:鲍南 高俜娉 宋云海 杨波 陈成 刊名:临床小儿外科杂志 上传者:杨德光

【摘要】目的研究背侧单纯性脊膜膨出与脊髓栓系的关系,探索单纯脊膜膨出合并脊髓栓系的诊断、手术时机及手术方式的选择。方法选择背侧单纯性脊膜膨出患儿69例,结合MRI及手术椎管腔探查所见,研究单纯性脊膜膨出与导致脊髓栓系的其它病变的关系。结果69例中,MRI及手术发现67例(占97%),患儿除单纯脊膜膨出外,还合并其它相关脊髓病变,如终丝牵拉、纤维束带、脊髓马尾神经粘连、脊髓纵裂、蛛网膜囊肿、表皮样囊肿等。手术修补膨出脊膜的同时,切除椎管内病灶,松解脊髓栓系,术后未见神经损害。结论单纯性脊膜膨出有很高的脊髓栓系伴发率,MRI是其必要检查。一旦确诊,建议积极手术治疗,术中不仅要修补膨出脊膜,还应探查椎管腔,解除脊髓栓系。

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临床小儿外科杂志 2015年12月第 l4卷第6期 Journal of—Clinical Pediatric Surgery,D—ecember 2015,Vo1.14,No.6 背侧单纯性脊膜膨出与脊髓栓系 鲍 南 高俜娉 宋云海 杨 波 陈 成 【摘要】 目的 研究背侧单纯性脊膜膨出与脊髓栓系的关系,探索单纯脊膜膨出合并脊髓栓系的 诊断、手术时机及手术方式的选择。 方法 选择背侧单纯性脊膜膨出患儿 69例,结合 MRI及手术椎 管腔探查所见,研究单纯性脊膜膨出与导致脊髓栓系的其它病变的关系。 结果 69例中,MPd及手术 发现 67例(占97%),患儿除单纯脊膜膨出外,还合并其它相关脊髓病变 ,如终丝牵拉、纤维束带、脊髓 马尾神经粘连、脊髓纵裂、蛛网膜囊肿、表皮样囊肿等。手术修补膨出脊膜的同时,切除椎管内病灶,松 解脊髓栓系,术后未见神经损害。 结论 单纯性脊膜膨出有很高的脊髓栓系伴发率 ,MRI是其必要检 查。一旦确诊,建议积极手术治疗,术中不仅要修补膨出脊膜,还应探查椎管腔 ,解除脊髓栓系。 【关键词】 单纯性脊膜膨出;脊髓栓系;诊断;外科手术;治疗结果 Simple meningocele and tethered cord syndrome.BAO Nan,GAO Ping-ping,YANG Bo,et a1.Department of Pediatric Neurosurgery,Shanghai Children’S Medical Center,Shanghai Jiaotong University School fo Medicine. Shanghai 200127,China. 【Abstract】 0bjefive TIle present study aimed to investigate the relationship between meningocele and tethered cord syndrome,diagnosis of meningocele associated with tethered cord syndrome,and when to perform surgery an d the best surgical procedure. M ethods Sixty-nine children with meningocele were an alyzed. The relationship between meningocele and other lesions causing tethered cord syndrome was studied by combining magnetic resonance imaging(MR/)nad intraoperative findings. Results The MRI results and intraoperative findings showed that 67 children(97%)had associated lesions such as tight filum terminale,fibrous band teth— ering,spinal cord or cauda equina adhesion,diastematomyelia,arachnoid cyst,na d epiderm oid cyst.The protru— ded meninges were repaired an d the intr

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