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脊髓脊膜膨出修补术后的脊髓拴系综合征：文献综述

Tethered Cord Syndrome After Myelomeningocele Repair: A Literature Update.

作者信息

Ferreira Furtado Leopoldo Mandic, Da Costa Val Filho José Aloysio, Dantas François, Moura de Sousa Camila

机构信息

Pediatric Neurosurgery, Vila da Serra Hospital, Nova Lima, BRA.

出版信息

Cureus. 2020 Oct 14;12(10):e10949. doi: 10.7759/cureus.10949.

DOI:10.7759/cureus.10949
PMID:33072445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7560491/
Abstract

Tethered cord syndrome (TCS) after myelomeningocele (MMC) repair (or secondary TCS) is a challenging condition characterized by neurological, orthopedic, and urological symptoms, which are combined with a low-lying position of the conus medullaris and damage to the stretched spinal cord owing to metabolic and vascular derangements. It has been reported that this syndrome affects, on average, 30% of children with MMC. In this review, we revisit the historical aspects of secondary TCS and highlight the most important concepts of diagnosis, treatment, and outcomes for secondary TCS as well as the current research regarding the impact of fetal MMC repair in the incidence and management of TCS. In the future, the development of synthetic models of TCS could shorten the learning curve of pediatric neurosurgeons, and research into the cellular proapoptotic features and increased inflammation biomarkers associated with TCS will also improve the treatment of this condition and minimize retethering of the spinal cord.

摘要

脊髓脊膜膨出（MMC）修复术后的脊髓拴系综合征（TCS，或继发性TCS）是一种具有挑战性的病症，其特征为神经、骨科和泌尿系统症状，这些症状与脊髓圆锥低位以及由于代谢和血管紊乱导致的脊髓拉伸损伤相关。据报道，该综合征平均影响30%的MMC患儿。在本综述中，我们回顾继发性TCS的历史方面，并强调继发性TCS诊断、治疗和预后的最重要概念，以及关于胎儿MMC修复对TCS发病率和管理影响的当前研究。未来，TCS合成模型的开发可能会缩短小儿神经外科医生的学习曲线，对与TCS相关的细胞促凋亡特征和炎症生物标志物增加的研究也将改善该病症的治疗，并最大限度减少脊髓再次拴系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/9dde8a3dc29d/cureus-0012-00000010949-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/99c0da7095b0/cureus-0012-00000010949-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/3119c30d9639/cureus-0012-00000010949-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/2fe9200e391b/cureus-0012-00000010949-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/9dde8a3dc29d/cureus-0012-00000010949-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/99c0da7095b0/cureus-0012-00000010949-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/3119c30d9639/cureus-0012-00000010949-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/2fe9200e391b/cureus-0012-00000010949-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df76/7560491/9dde8a3dc29d/cureus-0012-00000010949-i04.jpg

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本文引用的文献

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J Neurosurg Pediatr. 2020 May 29;26(3):269-274. doi: 10.3171/2020.4.PEDS19722. Print 2020 Sep 1.
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Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Incidence of Tethered Cord Syndrome in Infants With Myelomeningocele With Prenatal Versus Postnatal Repair.神经外科学会关于伴有或不伴有产前修补术的脊髓脊膜膨出婴儿中脊髓栓系综合征发生率的系统评价和基于证据的临床实践指南。
Neurosurgery. 2019 Sep 1;85(3):E417-E419. doi: 10.1093/neuros/nyz266.
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Fetoscopic Myelomeningocele Repair with Complete Release of the Tethered Spinal Cord Using a Three-Port Technique: Twelve-Month Follow-Up-A Case Report.采用三端口技术行胎儿镜下脊髓脊膜膨出修补术并完全松解脊髓栓系：12个月随访——病例报告
Diagnostics (Basel). 2022 Nov 28;12(12):2978. doi: 10.3390/diagnostics12122978.
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