Aguiar Carlos A, Mendoza-Lattes Sergio, Cobb Peter, Menezes Arnold, Weinstein Stuart L
Hospital Pequeno Principe, Ortopedia Pediatrica, R. Desembargador Motta, 1070 Curitiba, Parana, Brasil.
Iowa Orthop J. 2007;27:85-9.
The case of a four-year-old child is described who presented to our institution with cervicothoracic deformity and a two-year history of progressive paraparesis. His past medical history was significant for meningocele which was closed at age two months. Imaging studies revealed severe congenital kyphosis with a hypoplastic T3 vertebra, as well as a tethered filum terminale with a conus lipoma. The spinal cord was found to be severely compressed at the apex of the kyphotic deformity. Discussion is focused on the diagnosis of tethered cord syndrome, and treatment options. In particular, this case required careful thought on the order of events, which followed initial tethered cord release and removal of the conus lipoma, and subsequent kyphectomy and fusion of the upper thoracic spine. A favorable clinical outcome was obtained with complete reversal of the paraparesis.
本文描述了一名4岁儿童的病例，该患儿因颈胸段畸形及进行性双下肢轻瘫2年就诊于我院。其既往病史中重要的一点是患有脊膜膨出，在2个月大时接受了手术闭合。影像学检查显示严重的先天性脊柱后凸，T3椎体发育不全，以及终丝栓系合并圆锥脂肪瘤。发现脊髓在脊柱后凸畸形的顶点处受到严重压迫。讨论集中在终丝栓系综合征的诊断和治疗选择。特别是，该病例需要仔细考虑治疗步骤的顺序，即先进行终丝松解和圆锥脂肪瘤切除，随后进行胸椎上段椎体切除及融合术。双下肢轻瘫完全恢复，获得了良好的临床效果。
