成人脊髓栓系综合征的手术治疗

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1、万方数据·682·主坐挫经处型苤壹!!!!生!旦筮!Q鲞筮!翅垦!也』盟!些塑!坠强：』!!!!Q!垒：!!!：!!，堕!：!成人脊髓栓系综合征的手术治疗李智敏高俊关健杨众李永宁王任直．脊髓脊柱疾病．【摘要】目的探讨成人脊髓栓系综合征的手术治疗效果。方法回顾性分析2005年3月至2013年12月手术治疗的41例成人脊髓栓系综合征患者，其中男17例(41％)，女24例(59％)；平均31．6岁，平均病程6．7年。41例均采用神经电生理监测辅助显微外科手术。术后坚持随访，平均2．5年，并应用Hoffman功能分级评价手术疗效。结果所有患者均获得随访，无死亡病例，根据Hoffman功能分级，症状改善

2、11例(27％)，稳定30例(73％)。其中，5例脂肪瘤型脊髓栓系，症状改善1例；16例皮样囊肿及表皮样囊肿造成的脊髓栓系，症状改善3例；20例无占位病变性脊髓栓系，症状改善7例，均无加重病例。结论成人脊髓栓系综合征患者手术治疗可以改善症状，其效果与病程相关，早期治疗效果更佳。【关键词】脊髓栓系综合征；肿瘤；显微外科手术Sur#caltreatmentonadulttetheredcordsyndromeLiZhimin，GaoJu凡，GuanJian，玩昭Zhong，LiYongning，WangRenzhi．ChineseAcademyofMedicalSciences，PekingUni

3、onMedicalCollege，DepartmentofNeurosurgeryofPekingUnionMedicalCollegeHospita，Beifingl100730，ChinaCorrespondingauthor：LiYongning，Email：13901074129@139．corn【Abstract】0bjectiveTodiscusstheeffectsofsurgicaltreatmentonadulttetheredcordsyndrome．MethodsThedataof41adulttetheredcordsyndromepatientswhohadbeent

4、reatedwithsurgeryinneurosurgerydepartmentofPekingUnionMedicalCoHegeHospitalfrom2005to2013wereretrospectivelyanalyzed．Therewere17(41％)malepatientsand24(59％)female．Themeanageofthepatientswas31．6yearsoldandthemeanhistoryofthediseasewas6．7years．41patientshadallbeentreatedwithmicrosurgeryunderneurophysio

5、logicalmonitoring．Allpatientshadbeenfollowed—upwithameandurationof2．5yearsandthesurgicaleffectswerejudgedaccordingtoHoffmangradingsystem．ResultsAllpatientswerefoHowed—up．AccordingtoHoffmangradingsystem，theneurologicsymptomswereimprovedin11patients(27％)，maintainedin30(73％)．Of5caseswithlipomatethereds

6、pinalcord，thesymptomswereimprovedin1cases．Of16caseswithtetheredspinalcordcausedbydermoidcystandepidermoidcyst，thesymptomswereimprovedin3cases．Of20caseswithoutoccupyinglesionsoftetheredspinalcord，thesymptomswereimprovedin7cases．Andtherewasnodeterioratedcase．ConclusionsSurgicaltreatmentonpatientswhoha

7、dadulttetheredcordsyndromecotddimprovetheneurologicdeficits．Theeffectswererelatedtothehistoryofdisease．Betterprognosiscouldbegainedbyearliertreatment．【Keywords】Tetheredcordsyndrome；Tumor；Microsurgery脊