Muraszko K, Youkilis A
Department of Pediatric Neurosurgery, University of Michigan, Ann Arbor 48109-0339, USA.
J Neurooncol. 2000 May;47(3):271-81. doi: 10.1023/a:1006474611665.
Abnormal spinal embryogenesis is quite commonplace. While greater than 90 percent of these errors of embryogenesis leads to occult spinal dysraphism with minimal neurologic or orthopedic sequelae, there is a significant minority of these anomalies which leads to the formation of the so-called 'congenital tumors of disordered embryogenesis'. The purpose of this article is to discuss the embryology, presentation, diagnosis and management of the spinal dysraphic states with particular emphasis on those errors which lead to mass lesions in the spinal canal such as dermoids, epidermoids, lipoma/lipomyelomeningocoele and neurenteric cysts. We also include lesions such as dermal sinus tracts and thickened filum terminale in our discussion with particular emphasis on their relationship to the tethered cord syndrome. Proper surgical management of these various conditions necessitates a thorough understanding of their embryologic etiology and the anatomic/physiologic ramifications that such lesions have on the developing spinal cord.
异常的脊柱胚胎发育相当常见。虽然这些胚胎发育错误中超过90%会导致隐性脊柱裂，伴有轻微的神经或骨科后遗症，但仍有相当一部分此类异常会导致所谓的“胚胎发育紊乱性先天性肿瘤”的形成。本文的目的是讨论脊柱裂状态的胚胎学、表现、诊断和管理，特别强调那些导致椎管内肿块病变的错误，如皮样囊肿、表皮样囊肿、脂肪瘤/脂肪脊髓脊膜膨出和神经肠囊肿。我们在讨论中还包括诸如皮窦道和终丝增厚等病变，特别强调它们与脊髓栓系综合征的关系。对这些不同情况进行适当的手术管理需要全面了解其胚胎学病因以及此类病变对发育中的脊髓产生的解剖学/生理学影响。
