When I was a child, my parents always said, "Baby has a long tail" today, which means to grow up one year. But in the hospital, there will really be little guys with long or short "tails". What's the matter?
In fact, this is a disease called tethered cord syndrome, which is a syndrome of a series of neurological dysfunction and malformations due to various congenital and acquired reasons that cause the spinal cord or conus to be pulled. Because the traction of the spinal cord mostly occurs in the lumbosacral spinal cord, which causes the cone to be abnormally low, it is also called the low spinal cord. 90% of children's patients have subcutaneous masses in the lumbosacral region, 50% have skin sinus, meningocele, hemangioma and hirsutism. About 1/3 of children's subcutaneous lipomas grow laterally, and the other side is meningocele. The lumbosacral subcutaneous masses can be very large, which has attracted parents' attention due to aesthetic problems. Some children's sacral regions can have dermatophytes, forming tails.
Tethered cord syndrome has the following symptoms. 1、 Pain, the pain part of children is often difficult to locate or located in the lumbosacral area, which can radiate to the lower limbs; 2、 In the early stage of childhood patients, most of them have no or only lower limb dyskinesia, and symptoms appear with age, and gradually worsen; 3、 Sensory disorders, mainly sensory numbness or hypoesthesia of the sellar region skin; Bladder and rectum dysfunction, children with enuresis or urinary incontinence most common; There will also be lumbosacral skin abnormalities.
At present, the only way to treat tethered spinal cord is surgical release. The purpose of the operation is to remove osteophyte, fibrous septum, dural sleeve, release fibrous neurovascular bundle and its adhesion, release tethered spinal cord, correct local distortion and compression, restore microcirculation of the damaged part, and promote the maximum recovery of neural function.
Hunan Children's Hospital Emergency General Surgery Department Wan Yuhuan
