石志才 袁文 贾连顺 李家顺 侯铁胜 倪斌 石志才、侯铁胜 200433上海，长海医院骨科；袁文、贾连顺、李家顺、倪斌 上海长征医院骨科 中华骨科杂志 1999 0 19 2


    关键词：脊髓栓系综合征；外科；手术；诊断 期刊 zhgkzz 0 脊柱脊髓疾患 fur -->


    

【摘要】目的 研究成人脊髓栓系综合征(TCS)的临床诊断和治疗。方法 回顾性报告18例成人脊髓栓系综合征的临床资料。所有患者均经MRI证实并行手术松解；根据手术所见和影像学分析其致病机理及手术要点。结果 脊髓或圆锥的栓系原因各不相同，包括椎管内肿瘤(6例)、脊髓脊膜膨出(6例)、终丝增粗(3例)、脊髓双裂畸形(2例)及术后粘连(1例)。经8个月～5年随访，其中14例获得满意疗效。结论 成人TCS在临床表现及预后等方面有别于幼儿TCS。术中应避免损伤圆锥和马尾神经。病程过长及再栓系是疗效不佳的主要原因。

Diagnosis and Treatment of Tethered Cord Syndrome in Adults

SHI Zhicai ^* , YUAN Wen, JIA Lianshun, et al.

    ^* Department of Orthopaedics, Changhai Hospital, Shanghai 200433

【 Abstract 】Objective To study the clinical diagnosis and treatment of tethered cord syndrome(TCS) in adults. Methods The clinical data of 18 adults with TCS were reviewed.All patients were confirmed by preoperative MRI and the tethered conus were released surgically. The pathological mechanism and main point of operation were analysed according to the operative findings and the radiological data. Results The cord or conus is tethered by different factors which include intradural tumors (6 cases), myelomeningocele (6 cases), thickened filum terminale (3 cases),diastematomyelia (2 cases) and postoperative adhesion (1 case).Forteen of 18 cases obtained good results after 8 months to 5 years follow-up. Conclusions Clinical manifestation and prognosis of TCS in adults are different from that of TCS in children. Attention should be paid to avoid additional injury to cord and conus during operation. The duration from onset to operation and the retethering of the conus are the main reason leading to dissatisfied outcome.

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