儿童脊髓分裂畸形(附10例临床分析)

Split spinal cord malformation in children(a report of 10 cases)

目的 总结儿童脊髓分裂畸形的临床特点和诊断、治疗经验。方法 回顾性分析 10例脊髓分裂畸形 (splitspinalcordmalformations,SSCMs) ,男女各 5例 ,年龄 10月～ 11岁 (平均 5 6岁 ) ,术前脊柱X线平片 1例、CT 3例、CT脊髓造影 1例、MRI 9例 ,以Pang等方法分型。结果 I型SSCMs 7例 ,Ⅱ型SSCMs 3例。病变位置除 1例位于胸段外 ,其余均在腰段 ,8例至少有一个脊髓栓系的相关疾患。术后症状改善 7例 ,不变者 3例 ,无死亡及永久并发症。结论 MRI是诊断脊髓纵裂畸形及其伴发疾患最有效的非创伤性方法 ,但对SSCMs的分型 ,CT椎管造影 (CTM)优于MRI。随着年龄的增大 ,SSCMs引起神经损害的机会将会增加 ,因而 。

Objective To summarize clinical features and treatment experience of split spinal cord malformations(SSCMs) in children Methods Ten patients with SSCMs surgically treated were retrospectively analyzed There were 5 girls and 5 boys ranging in age from 10 months to 11 years(mean 5 6 years).Plain X-ray films of the spine were obtained in 1 patient, magnetic resonance imaging, computeed tomography(CT) and CT myelographys(CTM) were done in 3,1 and 9 patients respectively The malformations were classified according to the method of Pang Results Seven patients showed type I and 3 patients showed type Ⅱ SSCM The malformation located in thoracic segment in 1 case,in lumbar segment in 6 cases Eight patients had at least one associated spinal cord tethering After surgery,the condition in 3 patients was unchanged and in 7 patients was improved Conclusion MRI is the most effective method for diagnosing SSCMs,however,CTM is superior to other radiological tools in defining the type of SSCM The risk of neurological defects resulting from SSCMs increases with the age of patients,therefore,all patients should be surgically treated when diagnosed