摘要
目的总结圆锥位置正常型小儿脊髓拴系综合征(occult tethered cord syndrome,OTCS)的诊断及治疗经验。方法回顾性分析3例OTCS患儿的临床资料,包括临床症状、体征、影像学表现、手术治疗效果等。结果3例患儿术前MRI均显示脊髓圆锥位于第二腰椎椎体下缘以上,术后MRI显示脊髓圆锥位置无明显改变。3例患儿术中可见终丝增粗( >2mm)及脂肪化。3例患儿术前及术后均无下肢运动或感觉功能障碍。2例术后大小便功能障碍明显改善,1例术后无改善。结论OTCS的诊断需结合患儿临床表现及影像学特点,治疗上建议尽早行终丝离断术。
Objective To explore the clinical manifestations,diagnosis and treatment of pediatric tethered cord syndrome(TCS)with normal positioned conus medullaris.Methods The clinicopathological parameters of 4 children diagnosed with TCS with normal positioned conus medullaris were reviewed retrospectively.Results In all cases,the end of conus medullaris was above inferior margin of L2 vertebral body.There was no significant postoperative change of the position of conus.Intraoperatve findings showed a thickened( >2 mm)and thicker filum.None presented with dysfunction of lower extremities and no postoperative deterioration of motor or sensory function was observed.Two patients had improved bladder and bowel function while another two showed no improvement.Conclusion The diagnosis of pediatric TCS with normal positioned conus should be based on the clinical manifestations and imaging findings.Resecting filum terminale is indicated once diagnosed.
作者
林锦荣
许新科
李方成
Lin Jinrong;Xu xinke;Li fangcheng(Department of Neurosurgery,Municipal Women&Children s Medical Center,Guangzhou 510632,China)
出处
《临床小儿外科杂志》
CAS
2019年第2期103-106,共4页
Journal of Clinical Pediatric Surgery
关键词
神经管缺损
终丝
圆锥
大小便功能障碍
儿童
Neural Tube Defects
Filum Terminale
Conus Medullaris
Urination and Defecation Function Disturbance
Child
