胸腰椎II型硬膜外蛛网膜囊肿的手术治疗1例

R. A. Kovalenko, Y. I. Ryumina, V. Cherebillo, V. A. Kashin
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引用次数: 0

摘要

背景。脊髓硬膜外蛛网膜囊肿是蛛网膜通过硬脑膜现有缺陷的突出,起到瓣膜的作用。文献资料的诊断和手术治疗是由临床病例的描述,并没有共识的最佳方法来解决这个问题。目的:报道胸腰椎II型硬膜外蛛网膜囊肿的手术治疗。目的:分析该类囊肿的诊断及手术治疗方法。材料和方法。分析了PubMed搜索引擎截至2021年发表的所有成人脊髓硬膜外蛛网膜囊肿的诊断和治疗病例。本文报道了在俄罗斯圣彼得堡Almazov国家医学研究中心成功手术治疗II型胸腰椎硬膜外蛛网膜囊肿的临床病例。对已发表的硬膜外蛛网膜囊肿治疗结果的分析表明,外科医生面临的主要任务是识别和关闭囊肿与硬膜下间隙之间的交通。为了准确地确定硬脑膜缺损的定位并减少手术通路,许多作者认为计算机断层脊髓造影是有效的。尽管现有的诊断方法多种多样,但迄今为止还没有找到一种具体而准确的方法来可视化该缺陷。基于文献分析,可以说,关于该主题的出版物的稀少性使得即使是个别报告也具有相关性,并且目前没有办法提出针对此类囊肿的诊断和手术治疗的具体策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical treatment of epidural arachnoid cyst type II of the thoracic and lumbar spine: case report
Background. Spinal epidural arachnoid cysts are the protrusion of the arachnoid membrane through an existing defect in the dural, functioning as a valve. Literature data on diagnosis and surgical treatment are presented by descriptions of clinical cases and there is no consensus on the optimal approach to solving this problem.Aim. To present a clinical case of surgical treatment of epidural arachnoid cyst type II of the thoracic and lumbar spine; to analyze methods of diagnosis and surgical treatment of such cysts.Materials and methods. All cases of diagnosis and treatment of spinal epidural arachnoid cysts in adults published in the PubMed search engine by 2021 have been analyzed. A clinical case of successful surgical treatment of an epidural arachnoid cyst of the thoracic and lumbar spine of type II on the basis of the Almazov National Medical Research Centre (Saint Petersburg, Russia) is presented.Results. Analysis of the published results of treatment of patients with epidural arachnoid cysts showed that the main task facing the surgeon is to identify and close the communication between the cyst and the subdural space. To accurately determine the localization of the dura mater defect and minimize operative access, many authors consider computed tomography myelography to be effective.Conclusion. Despite the variety of existing diagnostic methods, a specific and accurate way to visualize the defect has not been found to date. Based on the analysis of the literature, it can be said that the rarity of publications on this topic makes even individual reports relevant, and today there is no way to propose a specific strategy for the diagnosis and surgical treatment of such cysts.
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