Zumkeller M B, Seifert V, Stolke D
Neurochirurgische Klinik, Medizinische Hochschule Hannover.
Z Kinderchir. 1988 Dec;43(6):384-90. doi: 10.1055/s-2008-1043489.
In this article 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 of the patients consisted of dermatological changes in the lumbosacral region, neurogenic foot deformities and genitourinary tract anomalies with disturbed bladder function. The diagnosis was confirmed by neuroradiological studies including lumbal myelography, spinal 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 are discussed.
在本文中,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栓系综合征临床体征的儿童病例。这些儿童就诊时的年龄从1个月至12岁不等。患者的典型症状和体征包括腰骶部皮肤改变、神经源性足部畸形以及伴有膀胱功能障碍的泌尿生殖道异常。诊断通过包括腰椎脊髓造影、脊柱计算机断层扫描以及最近才应用的磁共振成像等神经放射学检查得以证实。手术指征基于脊髓内脂肪瘤和脊髓栓系的放射学证据,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。