成年脊髓拴系综合征临床诊治(附14例报告)

The Clinical diagnosis and treatment in adult tethered cord syndrome (14 cases report)

目的 :观察成年脊髓拴系综合征临床表现 ,对其手术及疗效进行评价。方法 :对14例成年经MRI及手术探察证实为脊髓拴系综合征患者临床表现进行分析。手术采用脉冲式电刺激仪及显微外科技术 ,扩大狭窄椎管 ,切除占位病变 ,松解脊髓及粘连马尾神经 ,切断终丝。结果 :全部病例随访1年以上 ,手术后感觉、运动、括约肌及性功能得到较好改善 ,其改善率的95 %可信区间为 (29 %,82 % )。结论 :手术采取原发和继发疾病同时治疗 。

Objective:To observe the clinical manifestation in adult tethered cord syndrome(TCS)and evaluate the effect of operation and prognosis.Methods:The clinical manifestation in adult TCS diagnosed by MRI and operated exploration were observed.Pulse current stimuˉlated apparatus and microsurgical technique were used in operations.The methods including laminectomy,occupying mass removal,the release of spinal cord and adhesive canda equina and transection of terminal filament were adopted.Results:All cases were follower-up more than one year.After operations,The sensation,movement,sphincter and sexual functions were improved the improve rate was95%confidence interval was(29%to82%).Conclusion:There were positive effect of operative treatment to primary and secondary diseases together.