摘要
目的探讨单纯性脊膜膨出是否会合并脊髓栓系，是否应在行脊膜膨出修补术时探查椎管腔，解除脊髓栓系。方法观察上海儿童医学中心收治的单纯性脊膜膨出患儿38例，综合MRI及术中椎管腔探查所见，分析单纯性脊膜膨出是否合并其他导致脊髓栓系的病变。结果MRI及手术发现37例（97％）患儿除脊膜膨出外还合并有其他相关脊髓病变，如终丝牵拉、蛛网膜囊肿、表皮样囊肿、纤维束带、脊髓神经粘连等。脊膜膨出修补术中同时松解脊髓栓系，术后未见神经功能损害，长期随访患儿症状均改善或稳定。结论单纯性脊膜膨出常常伴有脊髓栓系，MRI是其必要检查。一旦确诊，建议积极手术治疗，术中除修补膨出脊膜外，还应解除脊髓栓系。
Objective To explain whether there is concurrent tethered spinal cord in meningocele, and whether it is necessary to perform intradural exploration simultaneously. Methods Data of 38 cases of pediatric meningoeele in Shanghai Children＇s Medical Center were studied. MR images and procedures were analyzed to identify whether there were associated lesions that may lead to spinal cord tethering. Follow-ups were performed to observe the therapeutic effects and prognoses. Results On MRI and operative results, 37 （97%） patients with meningocele had associated lesions that may lead to spinal cord tethering, including tight terminal filums, arachnoid cysts, epidermoid cysts, fibrous bands, adhesions of the spinal cord or nerves to dura, etc. The lesions were treated in the same operation. Postoperatively, 35 asymptomatic patients were neurologically intact, and 3 patients with symptoms had remarkable improvements or were kept stable. Conclusions Tethered cord syndrome is frequently concurrent with meningocele. Preoperation MRI is the modality of diagnosis. Meningocele repair, intradural exploration, and spinal cord unterthering are indicated simultaneously during the operation.
出处
《中华神经外科杂志》
CSCD
北大核心
2013年第6期547-549,共3页
Chinese Journal of Neurosurgery
