摘要
目的 探讨利用显微神经外科手术技术，治疗脊髓栓系综合征的疗效。 方法 对１９９４ 年～１９９７ 年共收治２２ 例脊髓栓系综合征的患者，术前均行 Ｍ Ｒ Ｉ检查，脊髓、圆锥尖端均位于 Ｌ２椎体下缘以下，骶尾部椎管内脂肪瘤４ 例、皮毛窦５ 例、单纯终丝增粗变短１３ 例。患者均采用腰骶部正中切口，手术范围包括圆锥下缘和终丝远端与骶部附着处。显微镜下分离马尾粘连，找出终丝，在圆锥下端切断终丝，并进行马尾神经梳理。对有脂肪瘤和皮毛窦应力争切除，松解脊髓圆锥，完整修复硬膜，防止粘连再栓系，随访半年至３ 年，２２ 例患者术后均有不同程度的好转。 结论 对脊髓栓系综合征患者应尽早明确诊断，尽早行显微神经外科手术。
Objective To evaluate the treatment results of 22 cases of spinal tethered cord syndrome(TCS)using microneurosurgical technique. Methods Form 1994 to 1997,22 cases of TCS verified by MRI were treated. All patients′tips of conus were below L 2 vertebra shown by MRI. In this group,4 cases had lipid disease in the sacral canal,5 piloidal sinus,and 13 thick filum. The patients were operated on using linear incision. The incision included the terminal conus and the whole filum. Under the microscope,the adhesions of the caudal equine were separated and the filum was found out. The caudal equine was well combed. Lipidoma and piloidal sinus were removed totally or partially. Loosening the spinal conus and repairing the dural matter prevented readhesion and retether. Results Follow up (0 5～3 years) showed that all of the patients were recovered in different levels. Conclusions TCS should be found as early as possible and treated under the microsurgical technique.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1999年第8期488-489,I033,共3页
Chinese Journal of Surgery
