Dehara M, Morimoto K, Takemoto O, Wakayama A, Nishikawa M, Hirano S
Department of Neurosurgery, Osaka Medical Center & Research Institute for Maternal & Child Health, Osaka, Japan.
No To Shinkei. 1999 Dec;51(12):1023-7.
Medullary conus-untethering operation was conducted on 52 infants with spinal lipoma. Magnetic resonance (MR) image was used in order to evaluate the untethering results in 44 out of these 52 patients who could be followed-up after Osaka Medical Center & Research Institute for Maternal & Child Health was opened. Talking into account the changes in vertebral body during the growth period of infants, the authors studied the upward displacement of the conus-lipoma interface by four fractional MR sagittal image, using the vertebral body-intervertebral disc space as the baseline. Upward displacement was confirmed in 27 of 44 (61.4%). The mean, median and trimmed mean of upward displacement were 1.78 +/- 0.80, 2.0, 1.70 fractions, respectively. Sixteen (59.3%) were caudal type, 10 (37.0%) were transitional type and 1 (3.7%) was dorsal type. By type of spinal lipoma, upward displacement was observed in 16 of 23 caudal type patients (69.6%), 10 of 16 transitional type patients (62.5%) and 1 of 5 dorsal type patients (20%). While the rate of upward displacement was almost equal between the caudal and transitional type, that of dorsal type was lower. However, statistical analysis for the difference in population percentage of the three groups showed that significant difference existed only in the caudal type group.
对52例患有脊髓脂肪瘤的婴儿实施了脊髓圆锥松解手术。在大阪母婴健康医学中心及研究所开业后,对这52例患者中的44例进行了随访,并利用磁共振(MR)图像评估松解效果。考虑到婴儿生长期间椎体的变化,作者以椎体-椎间盘间隙为基线,通过四张MR矢状位断层图像研究了圆锥-脂肪瘤界面的上移情况。44例中有27例(61.4%)证实存在上移。上移的均值、中位数和截尾均值分别为1.78±0.80、2.0、1.70个断层。16例(59.3%)为尾侧型,10例(37.0%)为过渡型,1例(3.7%)为背侧型。按脊髓脂肪瘤类型划分,23例尾侧型患者中有16例(69.6%)出现上移,16例过渡型患者中有10例(62.5%)出现上移,5例背侧型患者中有1例(20%)出现上移。尾侧型和过渡型的上移率几乎相等,而背侧型的上移率较低。然而,对三组人群百分比差异的统计分析表明,仅尾侧型组存在显著差异。