脊髓纵裂神经损伤的病理因素与治疗

Pathological factors and treatment of nerve injury of diastematomyelia

目的 探讨脊髓纵裂病理因素及其神经损伤机制 ,选择合理的治疗方法。方法 根据 70例脊髓纵裂患者的影像学资料、手术观察、尸解和临床表现 ,结合治疗方法与效果 ,研究其导致神经损伤的病理改变。结果 脊髓纵裂病理因素有 5个方面 :①先天性神经发育不良 ;②骨嵴与双管状硬脊膜 ;③脊髓水囊肿 ;④严重脊柱侧弯和异常神经根 ;⑤终丝及骶管肿瘤。结论 5种病理因素通过先天性缺陷、栓系和压迫机制导致脊髓发生病理变化 ,影响脊髓功能。应当选择切除骨嵴、硬脊膜成型、终丝切断。

Objective To study the pathological factors and the mechanisms of nerve injury of diastematomyelia and select reasonable methods of treatment. Methods The pathological changes of the disease were analyzed according to imaging analysis, operation and autopsy observations,clinical manifestations, and the surgical management in 70 cases. Results 5 pathological phenotypes were showed as follows:(1)congenital nerve dysplasia;(2)the bony crest and the dural theca of the double tubular;(3)hydroma of spinal cord;(4)rotation and lateral curve of spinal column and anomaly nerve roots;(5)the filum terminale and the neoplasms of sacral canal. Conclusion The above pathological factors affect functions of the spinal cord by the congenital defect, tether and compression. The excision of the bony crest, reshaping of the spinal dura mater ,division of the filum terminal,interal drainage of the hydroma of spinal cord and correction of the congenital scoliosis can be considered as the therapy for the conditions.