CAJ | 학술논문

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.
목적 탐토단순성척막팽출시부회합병척수전계,시부응재행척막팽출수보술시탐사추관강,해제척수전계.방법 관찰상해인동의학중심수치적단순성척막팽출환인38례,종합MRI급술중추관강탐사소견,분석단순성척막팽출시부합병기타도치척수전계적병변.결과 MRI급수술발현37례(97％)환인제척막팽출외환합병유기타상관척수병변,여종사견랍、주망막낭종、표피양낭종、섬유속대、척수신경점련등.척막팽출수보술중동시송해척수전계,술후미견신경공능손해,장기수방환인증상균개선혹은정.결론 단순성척막팽출상상반유척수전계,MRI시기필요검사.일단학진,건의적겁수술치료,술중제수보팽출척막외,환응해제척수전계.
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 meningocele 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.