症状性Tarlov囊肿的发病机制与显微手术治疗(附20例分析)

Pathogenesis and microsurgical treatment of symptomatic Tarlov cyst: report of 20 cases

目的探讨症状性Tarlov囊肿的发生机制和治疗方法。方法回顾性分析20例Tarlov囊肿病人的临床资料。病人主要表现为腰骶部疼痛局部不适、下肢轻度无力、大小便功能障碍等。均经过MRI确诊,囊肿最大径10～41 mm,有不同程度的骶椎压迹。均行显微神经外科手术治疗,显微镜下可见囊腔上端有脑脊液沿神经根袖缓慢流入,囊壁本身或外侧有神经根;予自体脂肪和生物蛋白凝胶填塞囊肿腔。结果本组症状均消失或明显减轻,有效率100%。结论症状性Tarlov囊肿是囊肿与蛛网膜不完全性沟通导致囊肿不断增大而压迫神经所致。囊肿填塞并阻断其与蛛网膜下腔的沟通是手术治疗症状性Tarlov囊肿的有效手段。

Objective To explore the pathogenesis and microsurgical treatment of symptomatic Tarlov cyst.Methods Clinical data of 20 cases were analyzed retrospectively.Patients often presented with low back pain,lower limb weakness and fecal and urinary incontinence.The final diagnosis was established by MRI.The maximum diameter of the cyst on MRI was 10-41 mm.All patients were operated on microsurgically.Under the microscope,CSF was seen to slowly flow into cyst along the nerve sleeve,and nerve roots existed on or ou...