成人脊髓栓系综合征的显微手术治疗——附8例临床分析

Microsurgical Management of Tethered Cord Syndrome in Adults

目的:探讨成人脊髓栓系综合征(TCS)的临床特点和显微手术治疗效果。方法:回顾性分析了8例成人TCS的诊断情况和显微手术治疗的效果。结果:本组病例从发病到确诊最长时间为33年,最短4年,平均26年。手术对疼痛症状的效果明显,运动感觉功能的效果欠佳,最差的是泌尿系统症状,所有病例神经功能损害未再进一步加重。结论:TCS的早期诊断和手术是提高疗效的关键,而术中应用显微外科技术是保证手术成功、提高手术效果和防止再栓系的有力手段。

Objective: To evaluate the clinical features and the curative results on tethered cord syndrome(TCS) with mi-crosurgical operation in adults. Method: Eight patients with TCS confirmed by preoperative MRI were treated microsurgically and their clinical data were analyzed retrospectively. Results: The substantial delay time interval between onset and diagnosis were from 4 to 33 years, and 26 years on average. The operative treatment was quite effective to the pain symptom improvement and a little effective to the sensorimotor symptom improvement, but without obvious effects on bladder dysfunction improvement. The neurological status of all patients undergoing spinal cord untethering were stable at follow up. Conclusion:Early diagnosis and complete untelhering are the keys to a succeasful outcome, and microsurgical techniques are beneficial in spinal cord untethering process.