带蒂骶棘肌瓣在症状性骶管囊肿治疗中的应用

The application of pedicled sacrospinalis pedicle flap in symptomatic sacral canal cyst

目的探讨带蒂骶棘肌瓣在治疗症状性骶管囊肿(SSCC)的临床应用价值,报道其应用于临床的初步效果。方法自2002年8月-2008年4月,行囊肿壁大部分切除后应用带蒂骶棘肌瓣填塞交通孔法治疗具有明确交通孔的SSCC患者20例,其中L5-S1平面1例,L5-S3平面2例,S1平面2例,S1-S2平面5例,S1-S3平面3例,S2平面1例,S2-S3平面6例。结果随访1年～4年10个月,平均21.6个月。未发生皮下积液和脑脊液漏。术后MR复查示囊肿消失。症状完全缓解16例,部分缓解4例,所有患者均未见复发,恢复日常工作和生活。结论带蒂骶棘肌瓣填塞封堵交通孔法是治疗具有明确交通孔且术中有较多囊肿壁残留的SSCC的理想术式,明显优势表现在操作简单安全、充分消除残腔及有效防止复发。

Objective To research the clinical values of pedieled temporalis multifidus flap on the treatment of symptomatic sacral canal cyst （SSCC） and report first step＇s results. Methods 20 samples of SSCC with clear communicating hole were treated with excision of the most of the cyst wall and plugging the communicating hole with a block of pedieled saerospinalis pedicle flap from August,2002 to April,2008.Of all the patients,1 was in level of L5 to S1,2 were in level of L5 to S3,2 were in level of S1,5 were in level of S1 to S2,3 were in level of Si to S3,1 wes level of S2,6 were in level of S2 to S3. Results All the cases were followed up for 12 to 58 months,with an average time of 21.6 months. There were no amounts hypodermal and neurolymph otorrhea happened in all eases.The cysts disappeared after operation through MR examination. Of 20 patients, 16 cases recovered completely and 4 cases recovered partly. There were no recurrence. All patients returned his daily work and life. Conclusion This method of plugging the communicating hole with a block of pedieled flap is a satisfying technique to treat SSCC with clear eommunieating hole and much wall redundant in the operation,which has obvious advantages like performing easyly and safety,sufficiently eliminating the redundant cavity and effectively preventing the recrudesee.