[1]苑斌,陈民,王杭州.经单侧椎间隙入路手术治疗儿童终丝型脊髓栓系的疗效分析[J].临床小儿外科杂志,2019,18(02):95-98.
　Yuan Bin,Chen Min,Wang Hangzhou..Surgical treatment of tethered spinal cord caused by terminal filum through an unilateral intervertebral space approach.[J].Journal of Clinical Pediatric Surgery,2019,18(02):95-98.
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经单侧椎间隙入路手术治疗儿童终丝型脊髓栓系的疗效分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第18卷 期数: 2019年02期 页码: 95-98 栏目: 专题讨论 出版日期: 2019-02-25
Title:
Surgical treatment of tethered spinal cord caused by terminal filum through an unilateral intervertebral space approach.
作者:
苑斌; 陈民; 王杭州
苏州大学附属儿童医院神经外科（江苏省苏州市，215025）
Author(s):
Yuan Bin; Chen Min; Wang Hangzhou.
Department of Neurosurgery,Affiliated Children‘s Hospital,Soochow University,Suzhou,215025,China.
关键词:
终丝脂肪瘤;  脊髓栓系;  外科手术;  治疗;  儿童
Keywords:
Terminal Filum;  Tethered Spinal Cord;  Surgical Procedures; Operative;  Therapy;  Child
分类号:
R729 R651.2
文献标志码:
A
摘要:
目的探讨经单侧椎间隙入路手术治疗儿童终丝型脊髓栓系的方法和疗效。方法回顾性分析2015年1月至2018年8月经单侧椎间隙入路手术治疗的32例终丝型脊髓栓系患儿的临床资料。结果所有患儿经单侧椎间隙入路手术离断终丝，栓系完全松解。住院期间2例会阴部和下肢间断疼痛的患儿术后疼痛立即缓解，3例双下肢活动障碍的患儿术后肌力减退未有加重。32例出院后随访2~31个月，无一例出现新发神经系统症状。1例术前有排尿及排便功能障碍者术后无明显改善，其他二便障碍患儿术后排便功能均有所改善；1例外伤后单侧下肢肌力0级患儿术后6个月肌力恢复至4级，另外2例以肌张力高为表现的双下肢活动障碍患儿在康复治疗后明显改善。结论经单侧椎间隙入路手术治疗终丝型脊髓栓系符合微创外科手术理念，缩短了手术时间,具有出血少、创伤小、并发症少、不损害脊柱稳定性等优点，疗效满意。
Abstract:
ObjectiveTo explore the approach and efficacy of accessing unilateral intervertebral space for terminal filum in children with tethered spinal cord (TCS).MethodsThe clinical data were reviewed for 32 TCS children with terminal filum operated from January 2015 to August 2018.ResultsAll children were operated via unilateral intervertebral space.Terminal filum was successfully dissected and bolt completely released.During hospitalization,2 children with intermittent pain of perineum and lower limbs were relieved immediately postoperation and 3 children with motor disorders of both lower limbs did not aggravate.During a followup period of 2-31 months,no new neurological deficit occurred.One case of dysuria and defecation showed no significant postoperative improvement while other children with dysuria improved.In 1 case,muscle strength grade zero recovered to grade IV in unilateral lower extremity at 6 months postoperation while another two cases of high muscle tension in lower extremities improved significantly after rehabilitation.ConclusionOperating through unilateral intervertebral space is both effective and miniinvasive so that it shortens operative duration,reduces hemorrhage,trauma and complications and does not damage spinal stability.

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[1]鲍南,高俜娉,宋云海.背侧单纯性脊膜膨出与脊髓栓系[J].临床小儿外科杂志,2015,14(06):479.

更新日期/Last Update: 2019-02-26