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经前路切除巨大骶前脊膜膨出:病例报告及文献复习

Resection of a giant anterior sacral meningocele via an anterior approach: case report and review of literature.

作者信息

Ashley William W, Wright Neill M

机构信息

Department of Neurosurgery, Washington University School of Medicine, Saint Louis, MO 63110, USA.

出版信息

Surg Neurol. 2006 Jul;66(1):89-93; discussion 93. doi: 10.1016/j.surneu.2005.10.020.

Abstract

BACKGROUND

An anterior sacral meningocele is a rare form of spinal dysraphism that is sometimes associated with syndromes such as Currarino and Marfan syndromes. These lesions rarely cause neurological complications, but meningitis, sepsis, obstetric problems, and bowel and bladder difficulties are common secondary conditions. The lesions can even be fatal. Because these lesions usually do not regress spontaneously, surgical treatment is the standard for symptomatic or growing masses. The dural defect can be repaired with a variety of anterior or posterior approaches.

CASE DESCRIPTION

We present a case of a 16-year-old female patient with a giant nonsyndromic anterior sacral meningocele that we successfully treated using an open anterior approach. We discuss the treatment options and present a brief review of the literature.

CONCLUSIONS

Although the posterior approach remains the treatment of choice for most lesions, we believe that the anterior laparotomy provides excellent exposure and is a safe alternative approach for the treatment of selected lesions. Patients with these lesions should be cared for by a multidisciplinary team.

摘要

背景

骶前脊膜膨出是一种罕见的脊柱裂形式,有时与库拉里诺综合征和马凡综合征等综合征相关。这些病变很少引起神经并发症,但脑膜炎、败血症、产科问题以及肠道和膀胱功能障碍是常见的继发情况。这些病变甚至可能是致命的。由于这些病变通常不会自行消退,手术治疗是有症状或不断增大肿块的标准治疗方法。硬脊膜缺损可通过多种前路或后路方法进行修复。

病例描述

我们报告一例16岁女性患者,患有巨大的非综合征性骶前脊膜膨出,我们采用开放前路方法成功进行了治疗。我们讨论了治疗选择并对文献进行了简要回顾。

结论

尽管后路手术仍然是大多数病变的首选治疗方法,但我们认为前路剖腹术可提供良好的暴露,并且是治疗某些选定病变的安全替代方法。患有这些病变的患者应由多学科团队进行护理。

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