Kang Hyun-Seung, Wang Kyu-Chang, Kim Kwang Myung, Kim Seung Ki, Cho Byung Kyu
Department of Neurosurgery, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-914, South Korea.
Childs Nerv Syst. 2006 Sep;22(9):1111-21. doi: 10.1007/s00381-006-0088-5. Epub 2006 Apr 4.
The authors report results of preoperative and postoperative urodynamic studies (UDS) and prognostic factors of urologic outcome in cases of lumbosacral lipomas for which prolonged follow-up data were available.
The present series includes 42 consecutive cases of lumbosacral lipoma in patients aged 2 months to 15 years who underwent untethering operation during the period from 1986 to 1997. All of them underwent preoperative and postoperative UDS. At the last follow-up (mean duration of follow-up 108 months, range 44 to 176 months), 26 cases maintained social continence with or without intermittent catheterization. Young age (< or =12 months) at operation, preoperative absence of urologic symptoms, and absence of neurologic abnormalities were significantly correlated with favorable urologic outcome.
UDS in cases with lumbosacral lipomas is a valuable tool for detecting neurourologic abnormalities as well as for monitoring the postoperative course and guiding management. History taking and neurologic examination are also proved to be important aspects in the evaluation of children with lumbosacral lipomas, predictive of urologic outcome. Better urologic results are anticipated if surgery is performed when the child is 12 months old or younger.
作者报告了腰骶部脂肪瘤病例术前和术后尿动力学研究（UDS）的结果以及泌尿系统预后的预测因素，并提供了长期随访数据。
本系列研究包括1986年至1997年间连续收治的42例年龄在2个月至15岁之间的腰骶部脂肪瘤患者，所有患者均接受了脊髓栓系松解手术。他们均接受了术前和术后尿动力学检查。在末次随访时（平均随访时间108个月，范围44至176个月），26例患者无论是否间断导尿均能保持社会排尿自控。手术时年龄小（≤12个月）、术前无泌尿系统症状以及无神经学异常与良好的泌尿系统预后显著相关。
腰骶部脂肪瘤病例的尿动力学检查是检测神经泌尿系统异常、监测术后病程以及指导治疗的重要工具。病史采集和神经学检查在评估腰骶部脂肪瘤患儿时也被证明是重要方面，可预测泌尿系统预后。如果在患儿12个月及以下时进行手术，预期泌尿系统结果会更好。
