雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 21, Issue 10 （October 1993）

Neurological Surgery 脳神経外科 21巻10号（1993年10月発行）

Japanese English

症例

脊髄脂肪腫を合併した真のHuman Tailの1例 A Case of True Human Tail Accompanied with Spinal Lipoma 松尾孝之 ¹ , 古賀博明 ¹ , 森山忠良 ¹ , 山下弘巳 ² , 今里賢一郎 ³ , 近藤方彰 ³ Takayuki MATSUO ¹ , Hiroaki KOGA ¹ , Tadayoshi MORIYAMA ¹ , Hiromi YAMASHITA ² , Kenichirou IMAZATO ³ , Masaaki KONDO ³ ¹佐世保市立総合病院脳神経外科 ²長崎大学脳神経外科 ³佐世保市立総合病院形成外科 ¹Department of Neurosurgery, Sasebo City General Hospital ²Department of Neurosurgery, Nagasaki University School of Medicine ³Department of Plastic Surgery, Sasebo City General Hospital キーワード： Human tail , Spina bifida , Tethered cord , Spinal lipoma Keyword: Human tail , Spina bifida , Tethered cord , Spinal lipoma pp.925-929

発行日 1993年10月10日 Published Date 1993/10/10

DOI https://doi.org/10.11477/mf.1436900724

PDF(8211KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　古くからよく知られた奇形であるhuman tailは，胎生6週頃に起こる胎尾の退化の過程が正常に進まないために発生すると考えられており，現在までにも100例以上の報告がなされているが，尾椎を含む真のhuman tailの報告は少ない．

　今回われわれは腰部脊髄脂肪腫，二分脊椎を合併した尾椎を含む真のhuman tailの1例を経験したので，若干の文献的考察を加えて報告する．

Human tails have been attributed to a disturbance in fetal tail regression which normally occurs at the gesta-tion age of about 6 weeks. To (late, more than WO cases of human tails have been reported. However, re-ports of true human tails, which involve the coccygeal vertebrae, are rare. We recently encountered a patient with a true human tail which involved the coccygeal vertebrae and was accompanied by lumbar spinal lipo-ma and spina bifida.

A four-year-old boy was brought to our clinic with complaints primarily of painful mass. The boy had no neurological abnormalities. Physically, a tail bone pro-jected, slightly in the lumbar area, with a linear de-pression in the center. A hard tail bone was palpable subcutaneously. A soft mass was palpable in the lum-bar region, which was accompanied by hemangioma on the superficial layer of the skin in this region. On X-ray films, the tail bone lacked the normal curvature and it projected linearly in the posterior direction. CT scans revealed spina bifida at the level below L2. MRI dis-closed spina bifida (at the level below L2), spinal lipo-ma and a tethered cord. During surgery, the tail bone was first resected over a distance of one and a half ver-tebral bodies. The lumbar tumor, which continued into the spinal canal, was removed as completely as possible after incision of the dura mater. To free the tethered cord, the tensioned, hypertrophic filum terminale was dissected.

Although the morphological diagnosis of this condi-tion is easy, the high incidence of complication by other anomalies makes it essential to perform thorough preoperative examinations with CT and MRI. Both the human tail involving the coccygeal vertebrae and the human tail that does not involve the coccygeal verte-brae can be satisfactorily treated by simple resection. Occasionally, restiform material or lipoma extends into the spinal canal. If these lesions are left untreated, tethered cord syndrome can develop. In such cases, tethering needs to be freed by resecting the lipoma and other lesions as completely as possible.