The hysteroscopy IUD remove difficult clinical analysis of 60 cases


The examination showed: lumbosacral laminectomy defect,ralph lauren sale, spinous absence. MRI showed spinal cord low, located in the lumbosacral or caudal, local adhesion signs. The one cases of syringomyelia. 1_2 methods of preoperative methylene blue injection positioning required spinous. Using straight incision on the spinous process. Along the paraspinal muscles on both sides of the spinous process and lamina peel, revealing a defect of the spinous process and lamina. Bite in addition to the lamina of the lesion exposed dura mater. Usually visible to the spinal cord, cauda equina and vertebral lesions bulging tissue adhesion. The abnormal cartilage resection of the lesion, proliferative bone, thickened yellow ligament, scar, fibrous band caused by spinal stenosis and spinal cord compression, pathological tissue. Surgical exposure to the full, soft operation, carefully, and try to cauda equina adhesion organization separation, to avoid damage. To identify the spinal cord filum terminale determined. Such as the spinal cord of the final wire pull cone should be cut off. Visible spinal cord tension to reduce the conus to move up. Careful hemostasis, saline rinse clean, tightly sutured dura mater, and cover the gelatin sponge. 2 results after surgery to maintain the prone position and one week to give the neurotrophic drug application to the parallel exercise of bladder function. Four cases cured, 2 cases were effective, one cases of poor recovery due to the presence of syringomyelia. 3 discussion of the tethered cord syndrome (TCS), refers to the cone location within the spinal canal can not be moved to produce a series of neurological dysfunction and malformation syndrome caused by various diseases. Under normal circumstances, the embryo 2O, spinal cord,mbt outlet, the end of L. Level. The 4O weeks in the Ls level, infants born with spinal cord end position in the L plane. Embryonic spina bifida or exist spina bifida, scar adhesions, the final wire thickening. Causing spinal cord fixed to the lesion site, can not adapt to the elongation of the spine rising to form a tethered cord. Combined with split parts of the scar in the spine, gradually increased adhesion, thickening of the yellow ligament, muscle inserts Author: Kaifeng City, Henan Province People's Hospital of Neurosurgery, 475 002 [Article ID 1009-6647 (2005) 13-2465-01 Dayton the formation of secondary spinal stenosis, tethered spinal cord, nerve ischemia, degeneration aggravates the damage. The surgical aim of cutting the spinal cord to the final wire, the spinal cord slight downward shift caused by spinal cord tension increased alleviate spinal cord recovery from the tethered to its original position, freed from the adhesions in the spinal cord or cauda equina, to prevent spinal cord due to growth or movement caused by secondary damage, leaving the nervous system defects improved. The complexity of the procedure to determine its pathological changes. Reasonable surgical operation is necessary. 7 patients in this group, the operations were carried out under general anesthesia using microsurgical techniques. Skin incision and fascia, the careful separation of nerve tissue under the microscope with the dura mater,franklin marshall, fiber bundles, thickening of the filum terminale or intradural lipoma separation. Before the cut off end of wire should be to stimulate the final wire to clarify whether there is nerve root or nerve tissue of the functional and its adhesion to determine the cut end of wire. Lipoma of these locations should not be regarded as tumors, but part of the spinal cord. Lipoma should be isolated and from subdural free. Lipoma is separated from the spinal cord is very dangerous and unnecessary. The key to successful release of tethered spinal cord is the separation of the spinal cord and the dura mater. Tethered cord syndrome, early diagnosis and better treatment. With the continuous improvement of diagnostic techniques, tethered cord syndrome detection rate will be gradually increased. Surgical indications: nerve damage, neurological defects,ugg boots uk, deformities and feeling, movement, autonomic dysfunction should be timely to consider surgery. Surgery sooner the better,abercrombie and fitch france, in order to prevent further nerve damage aggravated. Some authors believe that before the emergence of progressive nerve damage, spina bifida occulta should surgical treatment. Because the nerve damage is irreversible. Concurrent intraspinal anomalies like spinal deformity, intramedullary dermoid cyst, lipoma, nerve root anomalies, spina bifida, etc. must be removed. Even in the absence of clinical symptoms, is also recommended to undergo surgery to prevent neurological deterioration l3. [
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