改良手术治疗先天性脊柱裂

目的探讨先天性脊柱裂的手术特点及治疗经验。方法脊柱裂是一种先天性疾病,本文总结了2000年9月~2006年7月收治的328例先天性脊柱裂患者的显微手术情况,年龄1d~3岁,平均3个月。其中脊膜膨出者125例(38.1%),脊髓脊膜膨出者115例(35.1%),脊柱裂伴脂肪瘤者88例(26.8%)。结果在手术治疗的328例患者中,临床症状改善者299例(91.2),无变化者21例(6.4%),症状加重者8例(2.4%)。结论对于脊柱裂的手术治疗,除了要去除局部硬脊膜囊及其他组织的压迫外,行椎管扩大探查、脊髓栓系松解、脊膜修补术也是很有必要的,这对于先天性脊柱裂的预后有非常大的作用。

Modified surgical treatment for congenital spina bifida

Objective To investigate the main features and experiences of surgical treatment of congenital spina bifida. Methods This study was conducted to analyse the microsurgical treatment of congenital spina bifida. 328 patients with spina bifida who were 1 d to 3 years old (average 3 months) and required surgery during September of 2000 to July of 2006 were included in this study. Of the 328 patients, 125 cases (38.1%) were meningocele, 115 cases (35.1%) were myelomeningocele, and 88 cases (26.8%) were spina bifida with lipoma. Results The surgical results were improved in 299 cases ( 91.2 %), not improved in 21 cases (6.4%), and worsened in 8 cases (2.4%). Conclusion Decompression of the dural sac is important in the surgical treatment of spina bifida. Enlargement and exploration of the spinal canal, loosening of the tethering and dura remedy, which are prognostic factors for the surgical results of spina bifida are also imperative.