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目的：研究腰骶部椎管内肿瘤合并脊髓栓系综合征的病理临床特征及手术处理要点。方法：分析１２例腰骶部椎管内肿瘤患者的临床资料和手术所见，从局部病理机制的角度探讨脊髓栓系的方式与临床表现之间的联系，并据此确定手术的原则。结果：腰骶部椎管内肿瘤以多种方式栓系脊髓和圆锥，其临床表现兼有马尾综合征及圆锥综合征的特征。脂肪瘤、畸胎瘤、室管膜细胞瘤、皮样或上皮样囊肿等椎管内肿瘤较易导致脊髓栓系，而脊索瘤、脊膜瘤及大多数神经鞘瘤等椎管内肿瘤则很少合并脊髓栓系综合征。结论：手术时应遵循显微操作、逆向剥离及解除栓系三大原则，以防术中牵拉圆锥加重损伤。
Objective: To study the pathological features of lumbosacral intraspinal tumor combined with tethered cord syndrome and the main points of surgical treatment. Methods: The clinical data and surgical findings of 12 patients with lumbosacral intraspinal tumors were analyzed. The relationship between the tethered cord system and clinical manifestations was explored from the perspective of local pathological mechanism, and the principle of surgery was determined accordingly. RESULTS: The lumbosacral spinal tumors were tethered to the spinal cord and cone in various ways. The clinical manifestations of the lumbosacral spinal tumors were both characteristics of cauda equina syndrome and conus medullaris. Lipomas, teratomas, ependymomas, epidermoid cysts, and other intraspinal tumors are more likely to cause tethered cords, while chordomas, meningioma, and most schwannoma are spinal tumors. Few Tethered Tether Syndrome. Conclusion: The three principles of micromanipulation, reverse detachment, and release of the tether should be followed during surgery to prevent the traction cone from aggravating the injury.