López Pereira P, Moneo J, Martínez Urrutia M J, Jaureguizar E
Unidad de Urología Infantil, Hospital La Paz, Madrid.
Actas Urol Esp. 1995 May;19(5):383-8.
Changes in bladder behaviour and neurological symptoms were evaluated in 47 patients underwent untethered spinal cord because of tethered cord syndrome secondary to myeloneningocele closure. Patients were located in 3 categories (A < or = 5 years, B 6-10 years and C > 10 years) in relation to age of treatment. After untethering 77% improved neurologically and the best results were evident in children whose condition was repaired promptly (90%). Urodynamic studies were performed in 33 patients before and after surgery. Fifteen had hyperreflexic bladders, six low compliance and 12 hyperreflexia disappeared in 4 and sphinteric resistance increased in 2. In patients with tethered cord syndrome, untethering is recommended treatment in preventing further, sometimes rapid neurologic dysfunction and better results are got in childs whose condition is repaired at an early ages.
对47例因脊髓脊膜膨出修补术后发生脊髓拴系综合征而行脊髓松解术的患者，评估其膀胱功能和神经症状的变化。根据治疗年龄将患者分为3组（A组≤5岁，B组6 - 10岁，C组＞10岁）。脊髓松解术后，77%的患者神经功能改善，病情得到及时修复的儿童效果最佳（90%）。对33例患者在手术前后进行了尿动力学研究。术前15例有膀胱反射亢进，6例顺应性降低，术后12例膀胱反射亢进消失，4例括约肌阻力增加，2例括约肌阻力升高。对于脊髓拴系综合征患者，建议行脊髓松解术以防止进一步的、有时是快速的神经功能障碍，早期修复病情的儿童效果更好。
