Jiang S N
Central Hospital, Hongkou District, Shanghai.
Zhonghua Wai Ke Za Zhi. 1990 Jul;28(7):400-2, 445.
Forty-two cases of neuromyelopathy after lower thoracic lumbosacral myelomeningocele or meningocele repairment were reported. The repaired ages were from newborn to 6 years old. Subsequently progressive paralysis of lower extremities with incontinence of bowel and urination were seen after the primary operation. It may be due to "tethered spinal cord syndrome" or postoperative adhesion. Removal of the scar of adhesions over the lower thoracic and lumbosacral region and neurolysis were performed. Following 3-30 months after operation we found out that recovery of bowel function in 38 cases (90.5%). Active urination was recovered in 13 cases (31%) and improved in 22 cases (52.4%). Motor dysfunction and paresthesis of the lower extremities were alleviated in 19 (73.1%) of the 27 cases. No case revealed aggravation of symptom due to operative procedure.
报告了42例下胸腰骶部脊髓脊膜膨出或脊膜膨出修补术后发生神经脊髓病的病例。修补年龄从新生儿至6岁。初次手术后出现下肢进行性瘫痪并伴有大小便失禁。这可能是由于“脊髓拴系综合征”或术后粘连所致。对下胸腰骶部区域的粘连瘢痕进行切除并进行神经松解术。术后3至30个月,我们发现38例(90.5%)肠道功能恢复。13例(31%)恢复自主排尿,22例(52.4%)有所改善。27例中的19例(73.1%)下肢运动功能障碍和感觉异常得到缓解。无病例因手术操作导致症状加重。