脊髓发育不良的外科病理解剖学研究

目的研究脊髓发育不良的临床病理解剖学。方法依据112例术前病史、体检、影像学、尿流和肛肠动力学、排尿性膀胱尿道造影(VCUG)、EMG检查评价并行脊髓手术治疗。术中观察脊髓形态学改变并留取组织学标本。结果按照椎管内病变及其脊髓病理解剖改变将其分为终丝拴系、脊髓粘连、脊髓脂肪瘤、囊性占位、脊髓纵裂、静态病变六型及若干亚型。结论脊髓发育不良主要为一进行性加重的动态病理过程,其脊髓神经损害的病理解剖学基础是椎管内病变及其脊髓、神经根的形态学改变,应尽早诊断和椎管内手术治疗以改善预后。

A study on surgical pathology of myelodysplasia

Objective To study the clinical pathomorphology on myelodysplasia. Methods 112 patients were evaluated and diagnosed prospectively depending on preoperative history, physical examination, MRI, VCUG, EMG, urodynamics and underwent surgical correction. The intraspinal anomalies and their relation with spinal cord were observed during the operations. Results The patients were divided into 6 types on the intraspinal anomalies and the morphological changes of spinal cords, including spinal cords tethered with pathosis of terminal filum, spinal cord tethered with fibrous adhesions, lipoma on spinal cord, intraspinal cyst, diastematomyelia and defect of spinal cords and /or nerve roots. Conclusions Myelodysplasia results from its intraspinal anomalies and the morphological changes of spinal cord and should be actively diagnosed and surgically treated to improve their prognosis.