摘要
本文分析了我院１９７８年５月～１９９４年７月４６例脊髓纵裂的临床特点，其中手术治疗３７例，非手术治疗９例，均伴先天性脊柱畸形。临床上病人大多有腰背部中线上皮肤异常，如毛发斑、皮窦或脂肪瘤等。大多有单侧或双侧下肢神经异常，部分有膀胱直肠括约肌障碍。特征性Ｘ线表现是：部分病人椎管中央见到纵行骨嵴，椎弓根间距增宽，但无椎弓根变扁，骨嵴部椎间隙狭窄，附件结构紊乱；脊髓造影示典型的“岛屿征”即中央性充盈缺损，造影剂柱被间隔分为两半。ＣＴ扫描示椎管中央有骨性或软骨性间隔，分隔脊髓，并清楚显示扩大的椎管、椎体及附件畸形等。４６例中，３７例手术切除纵裂间隔，总有效率９１％。本病严重影响儿童的生长发育，极易漏诊和误诊，诊断须靠Ｘ线检查和ＣＴ扫描等，手术是其有效的治疗方法。
Theclinicalmanifestationof46patientswithdiastematomyeliaseenfromMay,1978toJuly,1994,wereanalysed,37casesweretreatedsurgicaly.Mostofthecaseshadoneormoreabnor-malitiesoftheskinoverlyingthespine,suchasahairypatch,dermalsinusorlipoma;neuraldeficitinoneorbothlowerlimbs,ordisturbanceofbladderandrectumsphinterwerealosalsoobserved.Char-acteristicradiologicalfindingswere:spurinthecenterofthespinalcanal,fudsiformwideningofthespinalcanalandincreaseininterpediculardistancewithoutflatteningofthepedicles.Theintervertebraldiscswerenarrowedatthesiteofthespurandadjacentpart.Typicalmyelographyicalfeaturewas“is-land”sign-amidlinefilingdefectdividingthecontrastmediumcolumnintotwoparts.CTscanningfeaturewasosseousandcartilaginousseptuminthecenterofthewidenedspinalcanaldividingthespinalcordintotwoparts,vertebralandappendicularabnormities.Ofthe46cases,37weretreatedbysep-tumexcision,andthetotalefectiverateoftheoperationwas91%.Theinfluenceofgrowthanddevel-opmentonsickchildrenoccuredseversly,andmisseddiagnosisoccurredeasily.Diagnosisofdiastem-atomyelianecessarilydependsuponX-raysexaminationandCTscanning,andtheoperativetreatmentisanefectivemethod.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第2期97-100,共4页
Chinese Journal of Orthopaedics
关键词
脊髓纵裂
外科手术
DiastematomyeliaOperativetreatment
