脊髓栓系综合征的诊断与显微外科治疗

目的：探讨脊髓栓系综合征(TCS)的临床特点、手术治疗及效果。方法：回顾性分析我科自1998年9月～2004年1月收治的21例病人。结果：年龄最小4个月，最大50岁。显性脊柱裂10例，其中2例曾做过脊膜膨出修补术；隐性脊柱裂9例，2例无脊柱裂。常见的症状为小便失禁、足内翻畸形、腰腿痛。21例病人均有MRI检查结果，7例有椎管内占位性病变。17例经历了显微外科松解术。随访3个月～5年，平均2年，好转9例，无变化8例，4例失访。结论：有脊柱裂及典型症状者均应行MRI检查，尽早发现TCS，尽早手术充分松解被牵脊髓。

Diagnosis and Microsurgical Treatment of Tethered Cord Syndrome( Report of 21 cases)

Objective:To explore clinical features,surgical treatment and effectiveness in tethered cord syndrome.Methods:21 cases of tethered cord syndrome treated by microsurgery from 1998 to 2004 were retrospectively analyzed.Results:The age of patients ranged from 4 months to 50 years.Of a total of 21 cases,there were 10 bifida manifesta including 2 with secondary operation,9 spina bifida occulta and 2 no spinal bifida.Urinary incontinence,clubfoot,pain in lumbar and sacral region were common manifestations.MRI performed in 21 cases showed 7 interspinal tumors.17 cases underwent untethering microsurgery.The average duration of follow-up was 2 years (range,3 months to 5 years).9 of 21 cases weve improved and 8 of 21 were not improved after treatment.Conclusion:MRI should be done in patients with spinal bifida and typical presentations.It is importment that early diagnosis and complete untethering the spinal cord.