Wu Liang, Qiu Yong, Wang Bin, Yu Yang, Zhu Ze-zhang
Department of Spine Surgery, Gulou Hospital, Nanjing University Medical School, Nanjing 210008, China.
Zhonghua Wai Ke Za Zhi. 2006 Dec 15;44(24):1657-9.
To detect the prevalence of spinal cord abnormality in "idiopathic" left thoracic scoliosis and analyze its clinical significance.
From October 1997 to October 2003, 59 "idiopathic" left thoracic scoliosis were treated, including 31 males and 28 females. The age was from 7 to 44 years with an average of 15 years. The Cobb angle was from 15 degrees to 108 degrees with average 56 degrees . The holocord MRI was made for all patients.
Thirty-three patients were found cord abnormality, including 24 Chiari malformation with syringomyelia, 5 syringomyelia, 1 Chiari malformation with syringomyelia and diastematomyelia, 1 Chiari malformation with syringomyelia and tethered cord, 1 syringomyelia with tethered cord, and 1 Dandy-Walker malformation. The prevalence of spinal cord abnormality in left thoracic scoliosis was 56%. Compared to the left thoracic scoliosis without cord abnormality, the left thoracic scoliosis with cord abnormality had been found more in males and the patients with bigger Cobb angle (P < 0.05).
For left thoracic scoliosis, especially male patient or patient with bigger Cobb angle, associated cord abnormality should be highly suspected. Preoperative holocord MRI is very meaningful for this kind of patients.
检测“特发性”左胸弯脊柱侧凸脊髓异常的发生率，并分析其临床意义。
1997年10月至2003年10月，对59例“特发性”左胸弯脊柱侧凸患者进行治疗，其中男性31例，女性28例。年龄7至44岁，平均15岁。Cobb角15度至108度，平均56度。所有患者均行全脊髓MRI检查。
33例患者发现脊髓异常，其中24例为Chiari畸形合并脊髓空洞症，5例为脊髓空洞症，1例为Chiari畸形合并脊髓空洞症及脊髓纵裂，1例为Chiari畸形合并脊髓空洞症及脊髓栓系，1例为脊髓空洞症合并脊髓栓系，1例为Dandy-Walker畸形。左胸弯脊柱侧凸脊髓异常的发生率为56%。与无脊髓异常的左胸弯脊柱侧凸相比，有脊髓异常的左胸弯脊柱侧凸男性患者及Cobb角较大者更多（P<0.05）。
对于左胸弯脊柱侧凸，尤其是男性患者或Cobb角较大者，应高度怀疑合并脊髓异常。术前全脊髓MRI检查对这类患者非常有意义。
