脊髓拴系综合征的病理学观察

Pathological Changes of Tethered Cord Syndrome

目的：为观察脊髓拴系综合征患儿终丝及脂肪团块的病理改变，探讨其发病机制。方法：对１８例患儿术中取材，行光镜、电镜观察。结果：发现在终丝末端及脂肪瘤内，光镜下可见有大量的各种形态神经组织分布；电镜下见终丝内神经纤维髓鞘厚薄不均、电子密度高低不等，轴浆内线粒体呈缺氧性改变；随年龄增长，病理改变加重。结论：观察证实了神经被拴系、神经缺血。

Objective: To record the pathological changes of filum terminale and lipoma in patients suffering from tethered cord syndrome(TCS). Methods: Filum terminale and lipoma removed during surgery were studied with microscopy and electromicroscopy. Results: Light microscopy revealed nerve tissue of various forms whereas electromicroscopy showed that myelin sheath was of heterogenous thickness and density. Mitochondria in axon revealed anoxic changes. These changes became more prominent in older children. Conclusions: The study suggests that ischaemia and anoxia of lumbosacral cord are involved in tethered cord syndrome. It emphasizes the necessity of early treatment.