儿童椎管内肠源性囊肿(附五例报告)

Intraspinal enterogenous cyst in children: report of five cases

目的探讨儿童椎管内肠源性囊肿的临床表现、影像学检查及显微手术治疗。方法收集自1996年至2004年收治的5例椎管内肠源性囊肿的临床资料,结合文献加以回顾性分析。结果全部病例均为儿童,确诊后采用显微外科手术治疗,其中2例全切,2例次全切除,1例大部切除。无一例死亡。经病理报告证实均为肠源性囊肿,术后神经根痛症状基本消失。随访0.5￣2年,无一例复发。脊髓损伤的Frankel分级:E级4例,D级1例。结论儿童椎管内肠源性囊肿有典型的临床表现和MRI特征,其最佳治疗方法是早期确诊并采取显微外科手术方法切除。

Objective To study the clinical manifestations,MRI imaging and microsurgical experience of intraspinal enterogenous cyst in children. Methods The clinical data of 5 cases treated between 1996 to 2004 were analyzed retrospectively on the basis of literature review. Results The 5 patients who were all children were treated with microsurgery techniques. 4 cases were located in subdural extramedullary ventral part of the spinal cord. The other 1 was found located in lower cervical segment,which in subdural extramedullary dorsal part of the spinal cord. The clinical manifestations showed the pain of nerve root and signs of spinal compression. Total surgical removal was achieved in 2 cases,subtotal removal in 2 cases,and most resection in 1 case. No death occurred. According to Frankel grade for spinal cord injury,4 cases regained all motor and sensory function (grade E),1 case in grade D. Conclusion Intraspinal enterogenous cyst in children had typical clinical manifestations and MRI characteristics. The best therapeutic measures included early diagnosis and removal with microsurgery techniques at early stage.