Ohata K, Gotoh T, Matsusaka Y, Morino M, Tsuyuguchi N, Sheikh B, Inoue Y, Hakuba A
Department of Neurosurgery, Osaka City University Medical School, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
J Clin Neurosci. 2001 Jan;8(1):40-2. doi: 10.1054/jocn.2000.0731.
The authors describe a new surgical technique to minimise the postoperative recurrence of adhesion after microlysis of adhesion to treat syringomyelia associated with spinal adhesive arachnoiditis. A 47 year old male presented with numbness of the lower extremities and urinary disturbance and was demonstrated to have a case of syringomyelia from C1 to T2 which was thought to be secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis. Following meticulous microlysis of the adhesions, maximal expansion of a blocked subarachnoid space was performed by expansive duraplasty with a Gore-Tex surgical membrane, expansive laminoplasty and multiple tenting sutures of the Gore-Tex graft. Postoperatively, the syringomyelia had be en completely obliterated and improvement of the symptoms had been also achieved. The technique described may contribute to improvement of the surgical outcome following arachnoid dissection by maintaining continuity of the reconstructed subarachnoid space.
作者描述了一种新的手术技术，用于在粘连松解术治疗与脊髓粘连性蛛网膜炎相关的脊髓空洞症后，尽量减少术后粘连复发。一名47岁男性出现下肢麻木和排尿障碍，经检查发现患有C1至T2节段的脊髓空洞症，认为这是继发于与结核性脑膜炎病史相关的粘连性脊髓蛛网膜炎。在仔细松解粘连后，通过使用戈尔特斯手术膜进行扩张性硬脑膜成形术、扩张性椎板成形术以及戈尔特斯移植物的多处帐篷状缝合，对阻塞的蛛网膜下腔进行最大程度的扩张。术后，脊髓空洞症已完全消失，症状也得到改善。所描述的技术可能通过维持重建蛛网膜下腔的连续性，有助于改善蛛网膜解剖术后的手术效果。
