One day at noon, a strange number called my mobile phone: "Dr. Zhao, do you still remember me? I had an operation at your place 7 years ago when my child was 50 days old, and now it seems to have relapsed. Look, What should I do?” After detailed inquiries, I learned that the child had indeed found a lump on his back after birth. An examination at the hospital revealed that there was a tumor on the spinal cord and myelomeningocele, which is a congenital disease. If the disease is not treated surgically as early as possible, it will affect the child's growth and development and subsequent defecation and defecation, so it was decided to undergo surgical treatment as soon as possible. At that time, surgery removed the tumor, loosened the adherent nerves, and removed the mass on his back. However, this congenital disease is easy to relapse. Even benign tumors and are easy to relapse, and once the nerves become adhesions again, defecation and defecation disorders and lower limb dysfunction may occur again. At that time, family members were clearly informed to remember to review every year.
However, the child's development has been normal in the past 7 years after the operation. He has gone to school normally, can defecate and defecate on his own, and can hardly see any problems when walking. So the family members also forgot to review again. This year, after a fall during exercise, the child began to wet the bed, struggled to defecate, limped, and had no strength in one leg. Then I asked the family to review the magnetic resonance imaging .
MRI clearly showed recurrence of the tumor, including lipoma , cyst , spinal cord tethering , all of which would affect the child's lower limbs and urination and defecation.
After detailed examination and careful discussion, we finally decided to have another surgery.
During the operation, it was found that the lipoma was tightly adherent to the spinal cord. The tumor tissue was removed under a high-power microscope, and absolute alcohol was used to cauterize the remaining lipoma capsule. The spinal cord cyst contained milky white cyst fluid, which should be enterogenic cyst . The cyst capsule was completely removed. During the operation, 3 tumors were also found to be adherent to cauda equina nerve . There were hair and tofu-like tissue in the tumors, which should be . teratoma. During the operation, the adherent cauda equina nerve was loosened as much as possible, and electrophysiological testing was used to protect functional nerve tissue.
The postoperative pathology also confirmed our intraoperative diagnosis.
Five days after the operation, the patient's lower limbs returned to the preoperative level
The postoperative MRI showed that all the tumors had been removed
After the operation, the patient still has difficulty in defecation and defecation. What should I do? Don't be afraid! Electromagnetic stimulation treatment was started on the second day after the operation. One month after the operation, the child's urinary and defecation functions were completely restored. Therefore, don’t be afraid when encountering spinal cord tumors . Even if paralysis and urinary and defecation difficulties occur after surgery, these are temporary. With early and effective electromagnetic stimulation, these functions can be restored, so don’t worry too much.
Director Zhao Dongsheng introduced: Teratoma is the most common germ cell tumor, derived from the primordial germ cells of the embryonic gonads. Most are composed of multi-dermal tissue, and most are benign. Teratomas can sometimes be found in bone, cartilage, hair, or brain and spinal cord tissue. This disease often occurs in children and young women, and only occasionally in postmenopausal women. mature teratoma can occur at any age, mostly between 20 and 40 years old. immature teratomas are more common in young patients, with the average age of onset being 11 to 19 years old.
Predisposing groups
Women in the childbearing period
Women in the childbearing period generally develop ovarian teratomas, accounting for about 15% of primary teratomas.
Infants and young children
During the development process of the embryo, its own cells do not develop normally, leading to the generation of teratomas.
Those who work under ionizing radiation
Ionizing radiation stimulates the human body and promotes abnormal differentiation of human cells to form teratomas
Typical symptoms
Ovarian teratoma
·Abdominal pain: When pedicle torsion occurs, severe pain may occur.
· Abdominal distension: A mass can be felt in the abdomen. In the short term, due to the rapid growth of teratoma, ascites may appear.
· Precocious puberty: breast development, early menstruation, etc. may occur.
Testicular teratoma
mainly manifests as swelling of the testicles and complications.
Sacrococcygeal teratoma
Because it occurs in the sacrococcygeal region, urinary system symptoms may occur, such as constipation and difficulty urinating.
If a child has difficulty in defecation or defecation, is incontinent, walks with a limp, has weakness in his lower limbs, , be sure to check the magnetic resonance imaging of the spine to exclude the possibility of spinal cord tethering and spinal cord tumors. Once discovered, surgery should be performed as soon as possible. Surgery is the first step, and the second step is The first step is to conduct electromagnetic stimulation treatment as early as possible, especially transcranial magnetic stimulation and traditional Chinese medicine treatment. In practice, the author of this article summarizes a set of methods that combine traditional Chinese and Western medicine plus electromagnetic stimulation to treat spinal cord injury and urinary and defecation dysfunction, which is called " "Trinity Therapy" has treated many patients with spinal cord injuries and spinal cord tumors. The author has repeatedly emphasized that before treating spinal cord tumors, you must ask whether the surgeon will treat the sequelae of spinal cord injury. If not, then in case of complications, For example, paralysis and incontinence, delaying the best treatment time will make the sequelae difficult to treat or even impossible to cure.
Director Zhao Dongsheng is the former deputy chief physician of the Neurosurgery Department of Xijing Hospital, and now serves as the deputy director of the Functional Neurosurgery Department of Xi'an Honghui Hospital
Clinic hours: Tuesday All day, Friday morning Clinic Room 310 on the third floor
Research field: Promotion of comatose patients Wake up, brainstem hemorrhage , hydrocephalus , cerebral infarction , brain tumor, spinal cord tumor, spinal cord injury paralysis, tethered spinal cord , syringomyelia , cerebral palsy , atlanto-occipital malformation, cerebellum Subtonsillar hernia deformity , urinary and fecal dysfunction, neuropathic pain, trigeminal neuralgia , hemifacial spasm, diabetic foot, peripheral nerve damage , etc.
