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成人脊髓脊膜膨出的神经整形手术:推进皮瓣重建术

Neuroplastic surgery for adulthood myelomeningocele: Advancement flap reconstruction.

作者信息

Burgos-Sosa Erik, Melo-Guzman Gustavo, Paz-Hernandez Diana Carolina, Bernes-Rodriguez Miguel Jesus, Acosta-Garces Ruben, Lima-Romero Alfredo, Taylor-Martinez Mario Alberto

机构信息

Department of Neurosurgery, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico.

Department of Plastic Surgery, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico.

出版信息

Surg Neurol Int. 2025 Jun 20;16:249. doi: 10.25259/SNI_11_2025. eCollection 2025.

Abstract

BACKGROUND

While it is widely recognized that surgical intervention is crucial at birth, the occurrence of giant myelomeningocele in adulthood is exceedingly uncommon. This case study aims to provide a comprehensive overview of a rare presentation of myelomeningocele accompanied by a tethered cord in an adult patient, highlighting the clinical features, diagnostic imaging, and surgical repair technique employed.

CASE DESCRIPTION

This patient is a 58-year-old woman with a history of spinal dysraphism that was diagnosed during childbirth. Due to her family's low sociocultural status, she did not receive timely treatment. She was referred to our institution because of a persistent increase in volume in the lumbar region, accompanied by a continuous and intense pulsating headache. An magnetic resonance imaging revealed a giant spinal defect caused by lumbar dysraphism. A surgical rotational flap procedure and untethering of the spinal cord using microsurgical techniques were performed. During follow-up, the patient experienced a complete recovery of her clinical symptoms.

CONCLUSION

Surgical treatment can benefit adult patients with symptomatic myelomeningocele. This would influence the quality of life for the patient. For large lesions in the spine, adequate flap rotation demands knowledge of how to do it.

摘要

背景

虽然人们普遍认识到手术干预在出生时至关重要,但成年期巨大脊髓脊膜膨出的发生极为罕见。本病例研究旨在全面概述一名成年患者罕见的脊髓脊膜膨出伴脊髓拴系表现,突出其临床特征、诊断性影像学检查以及所采用的手术修复技术。

病例描述

该患者为一名58岁女性,有分娩时诊断出的脊柱裂病史。由于其家庭社会文化地位较低,她未得到及时治疗。因腰部体积持续增大并伴有持续剧烈搏动性头痛,她被转诊至我院。磁共振成像显示由腰椎发育异常导致的巨大脊柱缺损。采用显微外科技术进行了手术旋转皮瓣手术并松解脊髓。随访期间,患者临床症状完全恢复。

结论

手术治疗可使有症状的成年脊髓脊膜膨出患者受益。这将影响患者的生活质量。对于脊柱的大病变,充分的皮瓣旋转需要了解如何进行操作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67f9/12255194/c13a5d3fe07d/SNI-16-249-g001.jpg

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