成人和儿童脊髓栓系综合征患者终末期脊髓空洞症及伴有先天性神经外科异常的临床意义

IF 0.3 Q4 PEDIATRICS Journal of Child Science Pub Date : 2022-01-01 DOI:10.1055/s-0042-1757142
Usame Rakip, Ihsan Canbek, Serhat Yıldızhan, M. Boyacı, Akın Cengiz, Adem Aslan
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引用次数: 0

摘要

磁共振成像(MRI)可用于检查脊髓栓系综合征(TCS)和终末期脊髓空洞症(TS)。此外,越来越多的证据表明先天性畸形与TCS之间存在关联。我们旨在确定儿童和成人TCS患者脊髓空洞症和其他异常的临床和放射学特征。本研究包括54名TCS患者(平均年龄17.37岁) ± 15.83年;31名女性)。患者被分为两个年龄组:儿科(18岁)。临床表现、直接脊椎X线片、下肢X线片和脊椎/颅骨MRI检查结果用于评估所有患者。计算机断层扫描(CT)显示了脊髓纵裂患者的隔膜结构。在儿童脑积水病例中,如果囟门打开或关闭,则分别进行颅骨超声或CT检查。进行盆腔超声检查和尿动力学检查,以评估其他合并症异常和泌尿系统病理。终丝增厚(73.3%)和脊髓纵裂(44.4%)可引起脊髓张力。最常见的伴随病理是脊髓空洞症(78%)。常见症状为尿失禁和肠道问题(71%)、脊柱侧弯(68%)和进行性下肢无力(64.4%)。TCS和TS患者的确切症状原因很难区分。由于伴随TCS的其他先天性脊柱异常发生率更高,儿童组的术前症状和临床表现都比成人组更严重,术后结果可能更为阴性。
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Clinical Significance of Terminal Syringomyelia and Accompanying Congenital Anomalies of Neurosurgical Interest in Adult and Pediatric Patients with Tethered Cord Syndrome
Magnetic resonance imaging (MRI) can be used to examine tethered cord syndrome (TCS) and terminal syringomyelia (TS). Additionally, there is increasing evidence of an association between congenital anomalies and TCS. We aimed to identify the clinical and radiological characteristics of syringomyelia and other anomalies in pediatric and adult patients with TCS. This study included 54 TCS patients (mean age, 17.37 ± 15.83 years; 31 females) admitted to our department between 2010 and 2019. The patients were divided into two age groups: pediatric (<18 years; 63%) and adult (>18 years). Clinical findings, direct vertebrae radiographs, lower extremity radiographs, and spinal/cranial MRI findings were used to evaluate all patients. Computed tomography (CT) was performed to reveal the structure of the septum in patients with Diastematomyelia. Cranial ultrasonography or CT was performed if the fontanel was open or closed, respectively, in pediatric hydrocephalus cases. Pelvic ultrasonography and urodynamic tests were performed to evaluate other comorbid anomalies and urinary system pathologies. A thick filum terminale (73.3%) and diastematomyelia (44.4%) were found to cause spinal tension. The most common accompanying pathology was syringomyelia (78%). The common symptoms were urinary incontinence and bowel problems (71%), scoliosis (68%), and progressive lower extremity weakness (64.4%). It is difficult to distinguish the exact cause of symptoms in patients with TCS and TS. Due to the greater occurrence of other congenital spinal anomalies accompanying TCS, both preoperative symptoms and clinical findings are more severe in the pediatric group than in the adult group, and postoperative results may be more negative.
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