Akay Kamil Melih, Izci Yusuf, Baysefer Alper, Timurkaynak Erdener
Department of Neurosurgery, Gulhane Military Medical Academy, Ankara, Turkey.
Neurosurg Rev. 2004 Apr;27(2):99-105. doi: 10.1007/s10143-003-0313-6. Epub 2003 Nov 15.
Although split cord malformations have been well documented in children, there is no consensus about their surgical indications and clinical course in adults because of their rarity. Medical records of nine young adult patients with split cord malformations were reviewed retrospectively. The most common complaint was radicular low back pain persisting more than 1 year, and the most common finding was hypertrichosis. Adult split cord malformation patients in our series had neither scoliosis nor foot deformities. Radiologically, all had low-situated conus medullaris. Eight of them underwent surgery. The radicular low back pain decreased in all the surgically treated patients at short-term follow-up but had not disappeared. Although pain originating from split cord malformations seems to be the most common surgical indication in adult patients and shows good short-term results, in our opinion long-term pain improvement is necessary for confirmation. According to our results, it seems that symptomatic young adults with split cord malformations are good candidates for complaint and deficit stabilization surgery.
尽管脊髓纵裂畸形在儿童中已有充分记载,但由于其在成人中罕见,关于其手术指征和临床病程尚无共识。我们回顾性分析了9例患有脊髓纵裂畸形的年轻成年患者的病历。最常见的主诉是持续超过1年的神经根性下腰痛,最常见的体征是多毛症。我们系列中的成年脊髓纵裂畸形患者既没有脊柱侧弯也没有足部畸形。影像学上,所有患者的圆锥均低位。其中8例接受了手术。所有接受手术治疗的患者在短期随访中神经根性下腰痛均有所减轻,但并未消失。虽然源于脊髓纵裂畸形的疼痛似乎是成年患者最常见的手术指征,且短期效果良好,但我们认为长期疼痛改善对于确诊是必要的。根据我们的结果,有症状的成年脊髓纵裂畸形患者似乎是进行症状和功能缺损稳定手术的合适人选。