脂肪瘤型脊髓栓系综合征的病理及治疗

Pathalogy and Treatment of Tethered Cord Syndrome with Lipoma

根据２３例患儿脂肪瘤与脊髓的关系，将脂肪瘤型脊髓栓系综合征分为圆锥上型、圆锥旁型和圆锥下型。各型有其相应的Ｘ线特征及临床症状。手术治疗应小块分次切除脂肪瘤避免副损伤，使脊髓尽量复位，仔细缝合硬膜切口预防脑脊液瘘。对於脂肪瘤以下部位感觉迟钝的病例应做改良切口，防止发生切口延迟愈合。

Based on the relationship between the lipoma and the spinal cord in 23 cases with tethered cord syndrome (TCS) ,the lipomatous TCS was classified into three types,namely supra-, para-, and infra-conus medullars respectively. They can be differentiated by X-ray features and clinical symptoms. At operation, lipoma should be resected carefully avoiding cord injury; the freed spinal cord should be reduced upward to a maximum; and the dura mater should be sutured neatly avoiding leakage.On patient with sensory loss. the skin incision should be carfully resected to avoid the delayed healing.