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目的：硬脊膜内皮样囊肿及囊性脊柱裂术后纤维疤痕粘连可造成继发性脊髓栓系，使得神经损害症状加重或产生新的症状．本文就该病的诊断及治疗进行分析．方法：囊性脊柱裂修补术后 １８例，硬脊膜内皮样囊肿５例。手术年龄２岁～１２岁，术后随访３月～１２月，对大小便失禁分别采用Ｋｅｌｌｙ评分法及Ｂｒｕｓｋｅｗｉｚ评分法．结果： １８例囊性脊柱裂，有的第一次手术后原有的神经损害症状进一步加重，有的产生新的症状． ＭＲ显示脊髓低位；在原手术处被纤维疤痕粘连牵拉，形成脊髓栓系。５例硬脊膜内皮样囊肿神经功能损害均为后天产生．ＭＲ显示皮样囊肿位于硬脊膜内，牵拉压迫脊髓、马尾．手术目的是切除病灶，将粘连牵拉的脊髓、马尾彻底松解开．术后随访，多数病人的大小便功能及双下肢功能均有不同程度的改善．结论：硬脊膜内皮样囊肿或先天性囊性脊柱裂手术后纤维疤痕粘连可造成脊髓栓系，产生神经损害症状或原有症状进一步加重．ＭＲ检查有助于诊断．脊髓栓系松解术有利于神经功能的改善。
OBJECTIVE: Secondary epidural cyst and cystic spina bifida fibroids adhesions can cause secondary tethered cord, making nerve damage symptoms or produce new symptoms. This article analyzes the diagnosis and treatment of the disease. Methods: Cystic spina bifida repair after 18 cases, 5 cases of epidural endodermal cyst. The operative age ranged from 2 years to 12 years and were followed up for 3 months to 12 months. Kelly and Bruskewiz scores were used for incontinence. Results: 18 cases of cystic spina bifida, some of the original after the first nerve damage symptoms further aggravated, and some new symptoms. MR showed low spinal cord; in the original surgical adhesions by fibrous scar traction, the formation of tethered cord. Neurodegeneration in 5 cases of epidural endodermal cysts were all acquired. MR showed dermoid cysts located in the dura mater, pulling the compression spinal cord, cauda equina. The purpose of surgery is to remove the lesion, the adhesions pull the spinal cord, ponytails thoroughly loosen. Follow-up postoperatively, the majority of patients with urinate and lower extremity function have varying degrees of improvement. CONCLUSION: Fibrous scar adhesions after endodermis-like cysts or congenital cystic spina bifida can cause tethered cord, resulting in neurological damage or further aggravation of the original symptoms. MR examination can help diagnose. Spinal cord lysis is conducive to improving neurological function.