Belzberg A J, Myles S T, Trevenen C L
Division of Neurosurgery, Alberta Children's Hospital, Calgary.
J Pediatr Surg. 1991 Oct;26(10):1243-5. doi: 10.1016/0022-3468(91)90343-r.
Recent publications have endeavoured to differentiate between the true, or vestigial tail, and the pseudotail by clinical and pathological examination, and have indicated the benign nature of the true tail. The true tail arises from the most distal remnant of the embryonic tail, contains adipose, connective, muscle, and nerve tissue, and is covered by skin. Pseudotails represent a variety of lesions having in common a lumbosacral protrusion and a superficial resemblance to vestigial tails. A review of the case reports indicates spina bifida to be the most frequent coexisting anomaly with both. A review of occult spinal dysraphism shows it to be associated with cutaneous signs in more than 50% of instances. Three cases of spinal dysraphism with tail-like cutaneous structures are described and their radiological, operative, and pathological findings presented. The classification of each of the appendages into true tail or pseudotail remains obscure. Although the finding of these three tails was the subject of much curiosity, surgical treatment was clearly designed to adequately deal with the associated dysraphic state. The presence of a tail-like appendage in the lumbosacral region should alert the clinician to the possibility of underlying spinal dysraphism. Preoperative assessment must include a complete neurological history and examination as well as computed tomographic or magnetic resonance imaging.
近期的出版物试图通过临床和病理检查来区分真正的或退化尾与假尾，并指出了真正尾巴的良性本质。真正的尾巴起源于胚胎尾巴的最远端残余部分，包含脂肪、结缔组织、肌肉和神经组织，并被皮肤覆盖。假尾代表了多种病变，它们的共同之处在于腰骶部突出，并且在外观上与退化尾有相似之处。对病例报告的回顾表明，脊柱裂是这两种情况最常见的共存异常。对隐性脊柱裂的回顾显示，在超过50%的病例中它与皮肤体征相关。本文描述了三例伴有尾状皮肤结构的脊柱裂病例，并展示了它们的放射学、手术和病理结果。将每个附属物分类为真正的尾巴或假尾仍然不明确。尽管这三条尾巴的发现引起了很多人的好奇，但手术治疗显然是为了充分处理相关的脊柱发育异常状态。腰骶部区域出现尾状附属物应提醒临床医生注意潜在脊柱裂的可能性。术前评估必须包括完整的神经病史和检查以及计算机断层扫描或磁共振成像。
