Wang YueLong, He Bin, Yang Jinhao, Xu Jianguo, Liu Jiagang, Huang Siqing
Department of Neurosurgery, West China Hospital.
Department of Obstetrics, West China Second Hospital, Sichuan University, Chengdu, PR China.
Medicine (Baltimore). 2020 Apr;99(14):e19631. doi: 10.1097/MD.0000000000019631.
Anterior spinal meningoceles are rare neuroanatomic abnormality formed by protrusion of the spinal meninges through a defect in the vertebral column. Presently, therapeutic options for anterior spinal meningoceles are still controversial. The objective of this study is to discuss the individualized management of giant anterior spinal meningoceles.
We analyzed 4 patients with anterior spinal meningoceles between 2007 and 2014 in our department by retrospective chart review, two of whom were anterior sacral meningoceles (ASMs), and another2 were intrathoracic meningoceles (ITMs).
Patients mainly presented with compressive symptoms including rectal irritation, dyspnea (patient 3) and fixed neurologic deficits (patient 4). Three out of 4 patients received surgical treatment, one of which underwent reoperation. After surgery, meningoceles in 1 patient completely disappeared. Two patients acquired the stability of the size of the meningoceles.
Management of anterior spinal meningoceles often requires precise treatment based on the different conditions of each patient. Surgical intervention has been proposed for the treatment of symptomatic anterior spinal meningoceles. The goal of surgery is to safely disconnect the linkage between the cyst and CSF from subarachnoid space to prevent further enlargement of the cyst or reaccumulating of cystic fluid.
脊髓脊膜膨出是一种罕见的神经解剖学异常，由脊髓膜通过脊柱缺损处突出形成。目前，脊髓脊膜膨出的治疗方案仍存在争议。本研究的目的是探讨巨大脊髓脊膜膨出的个体化治疗。
我们通过回顾性病历审查分析了2007年至2014年在我科就诊的4例脊髓脊膜膨出患者，其中2例为骶前脊膜膨出（ASM），另外2例为胸段脊膜膨出（ITM）。
患者主要表现为压迫症状，包括直肠刺激症状、呼吸困难（患者3）和固定性神经功能缺损（患者4）。4例患者中有3例接受了手术治疗，其中1例接受了再次手术。术后，1例患者的脊膜膨出完全消失。2例患者的脊膜膨出大小保持稳定。
脊髓脊膜膨出的治疗通常需要根据每个患者的不同情况进行精准治疗。对于有症状的脊髓脊膜膨出，已提出手术干预。手术的目标是安全地切断囊肿与蛛网膜下腔脑脊液之间的联系，以防止囊肿进一步增大或囊液再次积聚。
