Ahmed Shameem, Paul Siba Prosad
Consultant Neurosurgeon, Department of Neurosurgery, Apollo Hospitals, (Unit: International Hospital), Guwahati, India.
Consultant Pediatrician, Department of Pediatrics, Torbay Hospital, Torquay, UK.
Iran J Child Neurol. 2017 Spring;11(2):78-81.
Myelodysplasia includes a group of developmental anomalies resulting from defects that occur during neural tube closure. Urological morbidity in patients with myelodysplasia is significant and if not treated appropriately in a timely manner can potentially lead to progressive renal failure, requiring dialysis or transplantation. We report the case of a 13-year old girl with neurogenic bladder who presented chronic renal failure secondary to lipomyelomeningocele with retethering of cord. She was managed with urinary indwelling catheterization until optimization of renal function and then underwent detethering of cord with excision and repair of residual lipomeningomyelocele. Her renal parameters improved gradually over weeks and then were managed on self clean intermittent catheterization. The case emphasizes the need for considering retethering of spinal cord in children with myelodysplasia where symptoms of neurogenic bladder and recurrent urinary tract infections occur.
脊髓发育异常包括一组因神经管闭合期间出现的缺陷而导致的发育异常。脊髓发育异常患者的泌尿系统发病率很高，如果不及时进行适当治疗，可能会导致进行性肾衰竭，需要透析或移植。我们报告了一例13岁患有神经源性膀胱的女孩的病例，该女孩因脂肪瘤型脊髓脊膜膨出伴脊髓拴系继发慢性肾衰竭。她接受了留置导尿治疗，直到肾功能得到优化，然后进行了脊髓拴系松解术，并切除和修复了残留的脂肪瘤型脊髓脊膜膨出。她的肾脏参数在数周内逐渐改善，然后采用自行清洁间歇性导尿进行管理。该病例强调了对于患有脊髓发育异常且出现神经源性膀胱症状和反复尿路感染的儿童，需要考虑脊髓拴系的问题。
