每个半脊髓内伴有脂肪脊髓脊膜膨出的连续性脊髓纵裂——一种罕见的脊柱裂病例
Contiguous Diastematomyelia with Lipomyelomeningocele in Each Hemicord-an Exceptional Case of Spinal Dysraphism.
作者信息
Meena Rajesh Kumar, Doddamani Ramesh S, Sharma Ravi
机构信息
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
出版信息
World Neurosurg. 2019 Mar;123:103-107. doi: 10.1016/j.wneu.2018.11.225. Epub 2018 Dec 6.
BACKGROUND
Split cord malformation (SCM) is a rare congenital anomaly of the spinal cord. Rarely, SCM coexists with a variety of dysraphic pathologies that occur at the same or different spinal level in a patient. Exceptionally rare is the occurrence of SCM type 1 and lipomeningomyelocele of each hemicord.
CASE DESCRIPTION
A 15-month-old girl presented with gradually progressive, painless swelling in the lower back since birth. Spinal imaging showed the presence of type I SCM associated with lipomeningomyelocele of each hemicord. Surgical exploration and detethering was done.
CONCLUSIONS
Management of such complex cases of spinal dysraphism is challenging. Delineating their embryologic basis, detailed radiologic assessment, and meticulous microneurosurgical techniques are the cornerstone for successful management.
背景
脊髓纵裂畸形（SCM）是一种罕见的脊髓先天性异常。SCM很少与患者同一或不同脊髓节段出现的各种神经管闭合不全病变同时存在。1型SCM与每个半脊髓的脂肪脊髓脊膜膨出同时发生的情况极为罕见。
病例描述
一名15个月大的女孩自出生以来下背部出现逐渐加重的无痛性肿胀。脊柱影像学检查显示存在1型SCM并伴有每个半脊髓的脂肪脊髓脊膜膨出。进行了手术探查和松解。
结论
处理此类复杂的神经管闭合不全病例具有挑战性。明确其胚胎学基础、详细的放射学评估以及精细的显微神经外科技术是成功处理的基石。
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