脊髓栓系综合征合并脊髓空洞症患儿脑脊液流体动力学分析

目的　探讨脊髓栓系综合征（TCS）合并脊髓空洞症患儿脑脊液流体动力学变化。方法　选择2018年8月至2020年10月郑州大学附属郑州中心医院收治的15例TCS合并脊髓空洞症患儿为研究对象。所有患儿行神经电生理监测下显微镜通道脊髓终丝松解术。术后6个月对患儿进行随访,记录患儿术后临床症状恢复情况；比较患者手术前后脊髓空洞横截面积和脑脊液流体动力学指标。结果　术后6个月，所有患儿的腰背部疼痛、下肢痉挛、下肢无力、膀胱功能障碍、肛门括约肌功能障碍等临床症状均得到不同程度的缓解；患儿的脊髓空洞横截面积显著小于术前（P<0.05）,脊髓圆锥腹侧峰值流量及脊髓圆锥背侧峰值流量均显著多于术前（P<0.05）。结论　TCS合并脊髓空洞症患儿存在脑脊液流体动力学异常,终丝松解手术后，患儿的临床症状和脑脊液流体动力学情况得到改善，脊髓空洞横截面积缩小。

Analysis of hydrodynamics of cerebrospinal fluid in children with tethered cord syndrome and syringomyelia

Objective　To investigate the changes of hydrodynamics of cerebrospinal fluid (CSF) in children with tethered cord syndrome (TCS) and syringomyelia.
Methods　A total of 15 children with TCS and syringomyelia admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University were selected as the study subjects.All children underwent microscope channel filum terminale release surgery under electrophysiological monitoring.All children were followed up within 6 months after surgery,and the recovery of clinical symptoms of children were recorded.The cross-sectional area of syringomyelia and the hydrodynamics indexes of CSF of children were compared before and after surgery.
Results　At 6 months after surgery,the clinical symptoms of lumbosacral pain,lower limb spasms,lower limb weakness,bladder dysfunction and anal sphincter dysfunction of all children were alleviated to different degrees;the cross-sectional area of syringomyelia of children was significantly smaller than that before surgery (P<0.05),the ventral peak flow of the conus medullaris and the dorsal peak flow of the conus medullaris of children were significantly higher than those before surgery (P<0.05).
Conclusion　There are abnormal hydrodynamics of CSF in children with TCS and syringomyelia.After the filum terminale release surgery,the children′s clinical symptoms and the hydrodynamics of CSF were improved,and the cross-sectional area of syringomyelia become smaller.