Treatment Effect Analysis Of Tethered Cord Syndrome Caused By The Spinal Filament Lesionand And Treated By Of The Spinal Filament Transection

Background:Tethered cord syndrome is a series of neural dysfunction and malformation syndrome,it is a common nervous system disease with innate or acquired factors those result in cone position decreased,such as non elastic spinal cord ends tissue.In1976,Hoffman et al proposed the term of "tethered cord syndrome",and reported 31 cases with lower limb motor sensory dysfunction.The 31 patients’ clinical symptoms were improved after the spinal cord transection operation.The results show that good effect was achieved after the operation of spinal cord transection.With the development of MRI,it plays a positive role in the understanding of tethered cord syndrome.According to some reports,the incidence rate of simple tethered cord syndrome complicated with syringomyelia is about 22.5%~ 53%.There are a lot of patients troubled by simple tethered cord syndrome complicated with syringomyelia in clinical work,however,it is not clear about whether syringomyelia is caused by the tethered cord syndrome or not,good effect was achieved after the operation of spinal cord transection or not.Objective:To analyze the clinical effect of the operation(spinal cord transection)in the treatment of simple tethered spinal cord syndrome and simple tethered spinal cord syndrome combined with syringomyelia.Method:1.The Armed Police General Hospital in Beijing from January 2010 to December 2015 to be the research object.In order to investigate the effect of spinal cord transection in the treatment of simple tethered spinal cord syndrome and simple tethered spinal cord syndrome combined with syringomyelia,the simple tethered cord syndrome complicated with syringomyelia(n=56 cases)is compared with simple tethered cord syndrome(n=66 cases)in age,course of disease,and causes of tethered.Two groups of patients were followed up for a period of 1 years and 3 years,the results were analyzed with the follow-up data of the two groups respectively.2.All the patients were underwent MRI(MRI,Magnetic Resonance Imaging)scan(the posterior cranial MIR scan)to clarify the pathological characteristics of tethered cord,such as the thickening filum,the filum lipoma,the short filum,the filum like wing,the filum adhesion caused by scar and reducing the elasticity of filum etc,and exclusing other causes may result in syringomyelia,such as spina bifida,ring occipital malformation,myelomeningocele and diastematomyelia etc.Parameters of describing syringomyelia include,the length of cavity(vertebral segments),transverse diameter(mm),and the measurement of void index(syrinx index,axial cross section as the largest empty cavity area percentage of spinal cord area),syringomyelia reduction means syrinx index decreases more than 50% compared with preoperative.In order to improve accuracy and consistency,neurological function of all patients was evaluated to us the modified Japanese Orthopaedic Association(改良日本骨科评分,modified Japanese Orthopaedic Association).3.The age,duration of disease,the clinical data of the two groups patients was analyzed by chi-square using SPSS 22 statistical software,P<0.05 as the difference was statistically significant.Preoperative,1 years after surgery,the postoperative clinical data of 3 patients with SPSS 22 statistical software were analyzed by independent sample t test,P<0.05 as the difference was statistically significant.Result:There were no significant differences in the gender,age and clinical manifestations of the patients with simple tethered cord syndrome and those with simple tethered cord syndrome complicated with syringomyelia.statistical analysis: There was a significant difference between the preoperative and postoperative 1 year in patients with tethered cord syndrome(P<0.05),there was a significant difference between the preoperative and postoperative 3 years(P < 0.05),There was no significant difference between the postoperative 1 year and postoperative 3 years(P > 0.05).There was a significant difference between the preoperative and postoperative 1 year in patients with simple tethered spinal cord syndrome combined with syringomyelia(P<0.05),There was a significant difference between the preoperative and postoperative 3 years in patients with simple tethered spinal cord syndrome combined with syringomyelia(P<0.05),There was no significant difference between the postoperative 1 year and postoperative 3 years in patients with simple tethered spinal cord syndrome combined with syringomyelia(P>0.05).conclusion:1.There was a significant difference between the preoperative and postoperative 1year in patients with tethered cord syndrome2.There was no significant difference in the recovery of neurological function between the 1 year after the terminal filament transection and the 3 years after the terminal filament transection.3.There is a good clinical effect in the treatment of simple tethered cord syndrome and simple tethered cord syndrome complicated with syringomyelia.