Wada K, Morimoto K, Takemoto O
Department of Neurosurgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan.
No To Shinkei. 1998 Nov;50(11):989-93.
We studied morphological changes of hydromyelia complicated with spinal lipoma of infants who were untethered. Since the MRI was introduced, early detection of spinal lipoma with lumbosacral skin abnormalities has become possible. We have experienced 44 surgical cases of spinal lipoma. Out of 36 such cases, 25 (69.4%) had hydromyelia, and hydromyelia of 9 patients was found to be of the terminal ventricle type. As many as 36% of spinal lipoma patients with hydromyelia concurrently had terminal-type hydromyelia, which was considered to fall under a specific category of congenital hydromyelia. At the stage of embryogenesis of the spinal cord, the caudal cell mass undergoes vacuolization, canalization and retrogressive differentiation, and during this process, the terminal ventricle with ependymallined cells becomes morbid. Though the morphological changes of hydromyelia after surgery as untethering were varied, hydromyelia of 9 patients became smaller after untethering, and hydromyelia of 8 expanded but attenuated afterwards, totaling 17 (68.0%). However, 5 had an expanding tendency and 3 did not show any morphological changes during the follow-up period (20.6-26.9 months) by MRI.
我们研究了未受牵拉的婴儿脊髓空洞症合并脊髓脂肪瘤的形态学变化。自从引入MRI以来,早期发现伴有腰骶部皮肤异常的脊髓脂肪瘤已成为可能。我们经历了44例脊髓脂肪瘤手术病例。在36例此类病例中,25例(69.4%)患有脊髓空洞症,其中9例患者的脊髓空洞症为终室型。多达36%的合并脊髓空洞症的脊髓脂肪瘤患者同时患有终室型脊髓空洞症,这被认为属于先天性脊髓空洞症的一种特定类型。在脊髓胚胎发育阶段,尾侧细胞团经历空泡化、管道化和退行性分化,在此过程中,带有室管膜内衬细胞的终室发生病变。尽管解除牵拉手术后脊髓空洞症的形态学变化各不相同,但9例患者的脊髓空洞症在解除牵拉后变小,8例患者的脊髓空洞症扩大但随后有所减轻,总计17例(68.0%)。然而,5例有扩大趋势,3例在MRI随访期间(20.6 - 26.9个月)未显示任何形态学变化。