Hansasuta A, Tubbs R S, Oakes W J
Section of Pediatric Neurosurgery, Division of Neurological Surgery, Department of Surgery, University of Alabama at Birmingham, AL, USA.
Pediatr Neurosurg. 1999 Apr;30(4):176-9. doi: 10.1159/000028790.
The standard approach for sectioning of the filum terminale for a tethered spinal cord can be achieved via a limited S(1) exposure. This is performed with the commonly believed idea that the filum fuses with the dura at S(2). We dissected 27 cadavers to exclusively look at the level at which the filum pierces/fuses with the dura and also the level at which the dural sac ends. Most of the fila fused at S(2) with a range from L(5) to S(3). The majority of dural sacs ended at S(2) with a range from S(1) to S(3). However, 15% of the fila (4 of 27) fused above the S(1) level. In addition, 11% of the fila (3 of 27) fused off the midline. We hope that this anatomical information may be useful for neurosurgeons when standard approaches fail to identify the filum at its usual level and location.
对于脊髓拴系综合征，终丝切断的标准方法可通过有限的S(1)暴露来实现。这一操作基于普遍认为的观点，即终丝在S(2)处与硬脊膜融合。我们解剖了27具尸体，专门观察终丝穿透/融合硬脊膜的水平以及硬脊膜囊终止的水平。大多数终丝在S(2)处融合，范围从L(5)到S(3)。大多数硬脊膜囊在S(2)处终止，范围从S(1)到S(3)。然而，15%的终丝（27例中有4例）在S(1)水平以上融合。此外，11%的终丝（27例中有3例）偏离中线融合。我们希望当标准方法未能在其通常的水平和位置识别终丝时，这些解剖学信息对神经外科医生可能有用。
