[1]谢京城,陈晓东,杨军.脊髓圆锥马尾区畸胎瘤合并终丝牵张型脊髓拴系综合征的手术治疗[J].中国临床神经外科杂志,2023,28(03):156-159.[doi:10.13798/j.issn.1009-153X.2023.03.004]
　XIE Jing-cheng,CHEN Xiao-dong,YANG Jun.Surgical treatment of spinal cord teratomas in the region of spinal conus and cauda equina combined with Tethered cord syndrome due to filum terminale traction[J].,2023,28(03):156-159.[doi:10.13798/j.issn.1009-153X.2023.03.004]
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脊髓圆锥马尾区畸胎瘤合并终丝牵张型脊髓拴系综合征的手术治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年03期
页码:
156-159
栏目:
论著
出版日期:
2023-03-31

文章信息/Info

Title:
Surgical treatment of spinal cord teratomas in the region of spinal conus and cauda equina combined with Tethered cord syndrome due to filum terminale traction
文章编号:
1009-153X（2023）03-0156-04
作者:
谢京城; 陈晓东; 杨军
100191北京，北京大学第三医院神经外科（谢京城、陈晓东、杨军）
Author(s):
XIE Jing-cheng;  CHEN Xiao-dong;  YANG Jun
Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China
关键词:
脊髓肿瘤; 畸胎瘤; 脊髓拴系综合征; 显微手术
Keywords:
Spinal cord tumor;  Teratoma;  Tethered cord syndrome;  Microsurgery
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.03.004
文献标志码:
R739.42;R651.1+1
摘要:
目的 探讨脊髓圆锥马尾区畸胎瘤合并终丝牵张型脊髓拴系综合征（TCS）的临床特点、手术方法及其疗效。方法 回顾性分析2007年2月~2022年3月手术治疗的50例脊髓圆锥马尾区畸胎瘤合并终丝牵张型TCS的临床资料。结果 畸胎瘤内容物及囊性部分内壁剥离切除45例，囊壁次全切除加电灼5例；50例终丝均分离、切断。术后病理均为成熟囊性畸胎瘤及内终丝结构。术后随访6个月~14.5年，中位数75个月，按Hoffman脊髓功能评分，脊髓功能状态好转27例，不变22例，恶化1例；1例畸胎瘤内膜次全切除术后复发再次手术，其余49例未见肿瘤复发，无再拴系。结论 椎管内畸胎瘤多分布于脊髓圆锥马尾区，以慢性神经压迫为表现；对合并终丝牵张型TCS，一期行畸胎瘤切除术及终丝切断脊髓栓系松解术，疗效满意。
Abstract:
Objective To summarize the clinical characteristics and treatment experience of spinal cord teratomas in the region of spinal conus and cauda equina combined with Tethered cord syndrome (TCS) due to filum terminale traction. Methods The clinical data of 50 patients with spinal cord teratomas in the region of spinal conus and cauda equina complicated by TCS due to filum terminale traction who underwent surgery from February 2007 to March 2022 were retrospectively analyzed. Results Teratoma contents and cystic inner wall were dissected and excised in 45 patients, and subtotal excision and electrocauterization of cystic wall was performed in 5 patients. Filum terminales were separated and resected in all patients. Postoperative pathological results showed mature cystic teratoma and internal filum terminale structure in all patients. The follow-up ranged from 6 months to 14.5 years, with an average of 75 months. According to Hoffman spinal cord function score, the spinal cord function was improved in 27 patients, unchanged in 22, and worsened in 1. During the follow-up, 1 patient with subtotal resection of the cystic inner wall of teratoma recurred and was re-operated, and the other 49 patients did not recur. Conclusions Intraspinal teratomas are mainly located in the region of spinal conus and cauda equina, and is manifested by a chronic compression of spinal cord and nerve. One-stage resection of spinal cord teratomas and releasement of filar can obtain good outcomes in patients with TCS due to filum terminale traction.

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备注/Memo

备注/Memo:
（2022-12-11收稿，2023-01-22修回）
更新日期/Last Update: 2022-04-30