摘要
目的评估先天性脊髓拴系合并马尾神经疝的手术方法及疗效,并进行术后疗效的比较和相关问题的分析。方法回顾性分析2005年2月至2012年4月,北京中医药大学东直门医院23例脊髓拴系合并马尾神经疝的患者,行腰椎后路减压、硬膜切开、终丝切断、神经松解手术。收集患者的一般资料、影像学检查、手术方式、术后疗效及随访,观察患者临床疗效。结果 23例患者均成功完成手术。脊髓拴系合并马尾神经疝的患者表现为不同程度的马尾神经功能障碍、下肢畸形、马尾神经与硬膜不同程度的粘连。5例患者出现硬膜缺损、腰部神经根出口异常、椎管内巨大脂肪瘤。统计分析发现术后患者均出现不同程度的功能改善。结论对于脊髓拴系合并马尾神经疝的患者应考虑早期手术治疗,硬膜缺损者应修补硬膜,术中应仔细操作,防止神经损伤进一步加重。
Objective To evaluate the surgical methods and therapeutic effect of congenital tethered cord combined with cauda equeina dural herniation, and to compare the curative effect after operation. Methods A retrospective study was performed on 23 cases of patients with tethered cord and cauda equeina dural herniation in Dongzhimen Hospital from February 2005 to April 2012. The patients underwent posterior lumbar decompression and nerve release. The demographic data, imaging examination results, surgical methods, outcomes and follow-up were collected and the clinical curative effect of the patients were observed. Results Operations in the all 23 patients were successfully completed. 5 cases patients with dural defects, 2 intraspinal tremendous lipoma. Statistical analysis found that the function of patients after operation were improved in different degree. Conclusion Early surgical intervention should be considered in patients with tethered cord combined with cauda equeina dural herniation. The dural mater defect should be repaired when the dural defect was found, and it should be carefully operated to prevent the further nerve
出处
《中华疝和腹壁外科杂志（电子版）》
2016年第4期288-289,共2页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
马尾
脊髓拴系
Hernia
Cauda equeina
Tethered cord
