摘要
目的：研究腰骶部椎管内肿瘤合并脊髓栓系综合征的病理临床特征及手术处理要点。方法：分析１２例腰骶部椎管内肿瘤患者的临床资料和手术所见，从局部病理机制的角度探讨脊髓栓系的方式与临床表现之间的联系，并据此确定手术的原则。结果：腰骶部椎管内肿瘤以多种方式栓系脊髓和圆锥，其临床表现兼有马尾综合征及圆锥综合征的特征。脂肪瘤、畸胎瘤、室管膜细胞瘤、皮样或上皮样囊肿等椎管内肿瘤较易导致脊髓栓系，而脊索瘤、脊膜瘤及大多数神经鞘瘤等椎管内肿瘤则很少合并脊髓栓系综合征。结论：手术时应遵循显微操作、逆向剥离及解除栓系三大原则，以防术中牵拉圆锥加重损伤。
Objective: To study the pathological and clinical features and surgical main points of lumbosacral intraspinal canal tumour incorporated tethered cord syndrome. Methods: To analyse the clinical and surgical materials of 12 cases of lumbosacral intraspinal canal tumour. The relationship between the patterns of tethered cord and its clinical appearances was investigated throuth the local pathological mechanisms and based on it the operation principle was defined. Results: Lumbosacral intraspinal canal tumour tethered cord and conus in many ways. Its clinical manifestations included the features of cauda equina syndrome and conus syndrome . Lipoma, teratoma, ependymocytoma, dermoid cyst and epithelioid cyst were liable to lead to tethered cord syndrome, but notochordoma, meningioma and most of schwannomas were rare to complicate tethered cord syndrome. Conclusion: Operation principles should include micromanipulation, inverse decollement and tethering relief to avoid iatrogenic damage by drawing conus during operation.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1997年第6期560-562,共3页
Academic Journal of Second Military Medical University
