Sugawara Atsushi, Kim Kyongsong, Isobe Masanori, Matsumoto Ryoji, Isu Toyohiko
Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
Neurol Med Chir (Tokyo). 2009 Dec;49(12):616-8. doi: 10.2176/nmc.49.616.
Three men aged 40 to 60 years presented with rare lumbar spinal intradural lipomas without spina bifida manifesting as worsening numbness, pain of the lower extremities, and bladder dysfunction. All 3 patients underwent decompressive laminectomy. The lipoma and cauda equina nerves were dissected from the dura mater under the operating microscope, untethering the spinal cord and returning the cauda equina nerves to the original position. Duralplasty was performed using an expanded polytetrafluoroethylene sheet. Postoperatively, all patients experienced improvement of their neurological deficits. In the surgical treatment of spinal lipomas, the primary purpose is untethering and decompression, which can be achieved by untethering the spinal cord, returning the cauda equina nerves to the normal position, laminectomy, and duralplasty, without removal of the lipoma.
三名年龄在40至60岁之间的男性患者,患有罕见的无脊柱裂的腰椎硬膜内脂肪瘤,表现为下肢麻木、疼痛加重以及膀胱功能障碍。所有3例患者均接受了减压性椎板切除术。在手术显微镜下从硬脑膜分离脂肪瘤和马尾神经,松解脊髓并将马尾神经恢复到原来位置。使用膨体聚四氟乙烯片进行硬脑膜成形术。术后,所有患者的神经功能缺损均有改善。在脊柱脂肪瘤的外科治疗中,主要目的是松解和减压,这可以通过松解脊髓、将马尾神经恢复到正常位置、椎板切除术和硬脑膜成形术来实现,而无需切除脂肪瘤。