López Pereira P, Martínez Urrutia M J, Jaureguizar E, Perdiguero M
Sección de Urología Infantil, C.S. La Paz, Madrid.
Cir Pediatr. 1996 Apr;9(2):81-4.
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 complicance and 12 hyperreflexia plus low compliance. After treatment in 6 patients bladder dysfunction improved (18%), 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栓系综合征而接受脊髓松解术的患者，评估其膀胱行为和神经症状的变化。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。15例有膀胱反射亢进，6例顺应性降低，12例膀胱反射亢进合并顺应性降低。治疗后，6例患者膀胱功能障碍改善（18%），4例膀胱反射亢进消失，2例括约肌阻力增加。对于脊髓栓系综合征患者，建议进行脊髓松解术以预防进一步的、有时是快速的神经功能障碍，早期修复病情的儿童效果更佳。
