Hara Y, Shirane R, Yoshimoto T
Division of Neurosurgery, Tohoku University School of Medicine.
No Shinkei Geka. 1992 Nov;20(11):1217-21.
A case of anterior sacral meningocele associated with tethered cord syndrome is reported. A 5-year-old boy was admitted for urinary and fecal incontinence which had persisted since his birth. Abdominal MRI and sacral CT showed a presacral cystic mass communicating with the spinal dural sac through a neck traversing a sacral bony defect and tethered spinal conus. Neurological examination showed that the patient had a neurogenic bladder, atrophy of the legs and anesthesia below the S3 level. Operative finding revealed a thickened filum terminale attached to the wall of the presacral meningocele. Agenesis of the nerve root below the S2 level was identified, and no neural elements entered into the sac. Untethering was performed. Postoperative course was uneventful and the patient is doing well with his neurogenic bladder gradually improving.
报告一例骶前脊膜膨出合并脊髓拴系综合征的病例。一名5岁男孩因自出生以来持续存在的大小便失禁入院。腹部磁共振成像（MRI）和骶骨计算机断层扫描（CT）显示，骶前有一囊性肿块，通过一个穿过骶骨骨质缺损的颈部与脊髓硬膜囊相通，脊髓圆锥被拴系。神经学检查显示，该患者存在神经源性膀胱、腿部萎缩以及S3水平以下感觉缺失。手术发现终丝增粗并附着于骶前脊膜膨出的囊壁。发现S2水平以下神经根缺如，且无神经组织进入囊内。进行了脊髓松解术。术后过程顺利，患者情况良好，其神经源性膀胱逐渐改善。
