Murata Yasuaki, Kanaya Kohichi, Wada Hiroyoshi, Wada Keiji, Shiba Masahiro, Kato Yoshiharu
Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan.
Spine J. 2014 Oct 1;14(10):e1-3. doi: 10.1016/j.spinee.2014.02.031. Epub 2014 Mar 5.
A few reports have addressed tethered cord syndrome. Detethering surgery has been performed in these cases because abnormal tension on the spinal cord causes neurologic and urologic symptoms.
To discuss the surgical treatment of tethered cord syndrome with the belief that the tension on the cord can be decreased by shifting tethered cord to the dorsal side.
A patient with tethered cord syndrome was surgically treated by shifting the tethered cord to the dorsal side by harnessing the lumbar lordosis instead of detethering.
We performed surgery to shift the tethered cord to the dorsal side by harnessing the lumbar lordosis to decrease the tension on the spinal cord.
The tethered cord that was pressed to the ventral side because of a lipoma was shifted dorsally by laminectomy and opening of the dural sac. Pain and numbness were alleviated immediately after surgery.
The method used in the present case, that is, shifting the tethered cord and lipoma to the dorsal side by harnessing the lumbar lordosis instead of detethering, is a viable treatment option for tethered cord syndrome.
有少数报告涉及脊髓拴系综合征。在这些病例中已进行了脊髓松解手术，因为脊髓上的异常张力会导致神经和泌尿系统症状。
探讨脊髓拴系综合征的手术治疗方法，认为通过将脊髓拴系部位移至背侧可降低脊髓张力。
对一名脊髓拴系综合征患者进行手术治疗，通过利用腰椎前凸将脊髓拴系部位移至背侧而非进行脊髓松解。
我们通过利用腰椎前凸进行手术，将脊髓拴系部位移至背侧，以降低脊髓张力。
因脂肪瘤而被压向腹侧的脊髓拴系部位通过椎板切除术和硬脊膜囊切开术被移至背侧。术后疼痛和麻木立即得到缓解。
本病例所采用的方法，即通过利用腰椎前凸将脊髓拴系部位和脂肪瘤移至背侧而非进行脊髓松解，是脊髓拴系综合征的一种可行治疗选择。
