摘要
目的 研究脊髓纵裂临床病理分型及临床意义。方法 通过对 65例脊髓纵裂临床资料的回顾 ,根据影像学、病理解剖和临床表现 ,结合手术方法和效果 ,进行脊髓纵裂分型。结果 按硬脊膜形态及纵裂与脊髓关系分为双管型和单管型。双管型特征 :硬脊膜为两独立的次管 ,其内有各自分裂的半脊髓 ,两硬膜管间隙有骨性、软骨性或纤维性间隔。单管型硬膜管维持单管状 ,管腔扩大 ,其内有两个呈“镜影状”分裂的脊髓 ,少有间隔。结论 脊髓纵裂应按分型确定治疗方法。双管型应尽早手术治疗 ,如切除骨嵴 ,切断纤维性带状终丝 ,脊髓水囊肿内引流等。然后 ,进行先天性脊柱畸形矫正。单管型一般不主张脊髓探查 ,可考虑早期进行畸形脊柱的矫正治疗。
Objective To study the pathologic types of diastematomyelia and its clinical significance. Methods Diastematomyelia was classified according to imaging analysis, pathologic findings, clinical manifestations, and the surgical management in 65 retrospective cases. Results The cases diastematomyelia can be classified into two types; the double tubular and the single tubular type. In the double tubular type, the dural theca consists of two independent subtubes within each of which, there is half portion of the spinal cord and a bony, cartilaginous or fibrous septum in between. In the single tubular type, dural theca remains to be a single tube, however, the cavity of the dural theca is enlarged and the two spinal cords of mirror image exist normally without septum. Conclusion Diastematomyelia should be treated based on its type. The double tubular type should be treated surgically early with excision of the bony crest, excision and section of film like terminales, as well as internal drainage of hydroma of spinal cord. For the single tubular types early exploration should not be considered; early correction of the deformity of the spinal column should be the primary choice.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第2期69-71,共3页
Chinese Journal of Orthopaedics
关键词
脊髓纵裂
病理学
分型
矫正术
Spina bifida,occulta
Pathology
Cauda equina
