脂肪瘤型脊髓栓系综合征的病理及治疗

摘要

根据23例患儿脂肪瘤与脊髓的关系,将脂肪瘤型脊髓栓系综合征分为圆锥上型、圆锥旁型和圆锥下型.各型有其相应的X线特征及临床症状.手术治疗应小块分次切除脂肪瘤避免副损伤,使脊髓尽量复位,仔细缝合硬膜切口预防脑脊液瘘.对於脂肪瘤以下部位感觉迟钝的病例应做改良切口,防止发生切口延迟愈合.%Based on the relationship between the lipoma and the spinal cord in 23 cases with tethered cord syndrome (TCS), the lipomatous TCS was classified into three types, namely supra-, para-, and infra-conus medullars respectively. They can be differentiated by X-ray features and clinical symptoms. At operation, lipoma should be reseeted carefully avoiding cord injury;the freed spinal cord should be reduced upward to a maximum ;and the dura mater should be sutured neatly avoiding leakage. On patient with sensory loss, the skin incision should be carfully resected to avoid the delayed healing.