Management of tight filum terminale
Management of tight filum terminale
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DOI：
10.1055/s-2003-812463
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发表时间：
2004-02-01
影响因子：
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通讯作者：
Imakiire, A
中科院分区：
文献类型：
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作者：
Komagata, M;Endo, K;Imakiire, A
目的：紧丝终末（TFT）不是一种罕见的情况，但由于诊断方案不足，这种综合征往往被忽视和不及时治疗。本研究旨在探讨TFT的神经学角度和诊断方法的手术结果。方法：本研究的对象包括37例TFT患者，他们接受了横断终丝的手术治疗。我们检查了与腰痛、腿痛、膀胱和肠道功能障碍相关的手术结果，并分析了神经学和影像学结果。结果：TFT诊断依据以下5项标准；1)腰痛，2)非皮肤性腿痛，3)膀胱-肠功能障碍，4)脊柱僵硬，5)新开发的脊髓延伸阳性激发试验。结论：手术结果调查表明，在神经功能可逆的情况下，手术释放终丝可获得满意的效果。特别是，我们新设计的激发试验被证明对这种疾病的早期诊断非常有效。
Objective: Tight filum terminale (TFT) is not an uncommon condition, but due to insufficient diagnostic options this syndrome is often overlooked and left untreated. The present study was designed to investigate surgical results concerning neurological perspectives and diagnostic methods for TFTMethods: Subjects for this study consisted of 37 patients with TFT who were surgically treated by transecting the filum terminale. We examined the surgical outcomes with regard to low back pain, leg pain, and bladder and bowel dysfunctions, and analyzed neurological and imaging findings.Results: TFT diagnosis was based on the following five criteria; 1) low back pain, 2) non-dermatomal leg pain, 3) bladder-bowel dysfunction, 4) spinal stiffness, and 5) a newly developed positive provocation test for spinal cord extension.Conclusion: The survey of surgical outcomes indicated that satisfactory results could be obtained by surgical release of the filum terminale, while neural function was still reversible. In particular, our newly devised provocation test was shown to be highly effective for the early diagnosis of this disorder.