Stolke D, Zumkeller M, Seifert V
Neurosurgical Clinic, Medical School Hanover, West Germany.
Neurosurg Rev. 1988;11(1):59-65. doi: 10.1007/BF01795696.
The authors report on a series of 26 children with spina bifida occulta in combination with intraspinal lipoma and clinical signs of tethered cord syndrome. The age of the children at presentation ranged from 1 month to 12 years. The typical signs and symptoms consisted of skin lesions in the lumbar-sacral region, neurogenic foot deformities, and bladder and bowel disturbances. The diagnosis was confirmed by neuroradiological investigations including lumbar myelography, computerized tomography, and only recently magnetic resonance imaging. Indications for surgery were based on the radiological evidence of intraspinal lipoma and tethered cord and especially on the clinical signs of neurological deterioration. The results of the operative treatment are presented and the role of surgery before onset of symptoms as well as during the symptom-free interval is discussed.
作者报告了一系列26例隐性脊柱裂合并脊髓内脂肪瘤及脊髓拴系综合征临床体征的儿童病例。患儿就诊时年龄从1个月至12岁不等。典型的体征和症状包括腰骶部皮肤病变、神经性足部畸形以及膀胱和肠道功能障碍。诊断通过神经放射学检查得以证实，包括腰椎脊髓造影、计算机断层扫描，以及最近才使用的磁共振成像。手术指征基于脊髓内脂肪瘤和脊髓拴系的放射学证据，尤其是神经功能恶化的临床体征。文中呈现了手术治疗的结果，并讨论了在症状出现前以及无症状期进行手术的作用。
