Division of Orthopedic Surgery, Department of Neuro and Locomotor Science, Akita University School of Medicine, Akita, Japan.
Spine (Phila Pa 1976). 2009 Oct 15;34(22):E823-5. doi: 10.1097/BRS.0b013e3181af2607.
Retrospective case series.
To review findings from 3 patients who underwent spine-shortening vertebral osteotomy for tethered cord syndrome with a minimum follow-up of 3 years.
Surgical detethering is the gold standard for symptomatic tethered cord syndrome. However, complications such as cerebrospinal fluid leakage and neurologic deterioration are common. Spine-shortening vertebral osteotomy, proposed by Kokubun, is an alternative surgical technique to reduce neural tension indirectly. However, case series of this novel procedure for tethered cord syndrome have not been reported in the English literature.
Three patients aged 13, 22, and 27 years presented with progressive pain and/or neurologic dysfunction. They underwent spine-shortening vertebral osteotomy of L1 with a pedicle screw and rod system. Their clinical and radiologic outcomes are reviewed.
All patients got relief from their preoperative symptoms after surgery, and no complications occurred. Complete bone union was obtained in all patients without correction loss.
Spine-shortening vertebral osteotomy can be a safe and alternative surgical technique for tethered cord syndrome.
回顾性病例系列研究。
回顾 3 例接受脊髓缩短性椎体截骨术治疗脊髓栓系综合征的患者的发现，这些患者的随访时间至少为 3 年。
手术松解是有症状的脊髓栓系综合征的金标准。然而，脑脊液漏和神经功能恶化等并发症很常见。由小林提出的脊髓缩短性椎体截骨术是一种间接降低神经张力的替代手术技术。然而，英语文献中尚未报道过这种用于脊髓栓系综合征的新型手术的病例系列。
3 例年龄分别为 13、22 和 27 岁的患者出现进行性疼痛和/或神经功能障碍。他们接受了 L1 的脊柱缩短性椎体截骨术，使用了椎弓根螺钉和棒系统。回顾了他们的临床和影像学结果。
所有患者术后均缓解了术前症状，且无并发症发生。所有患者均获得了完全的骨性愈合，没有矫正丢失。
脊柱缩短性椎体截骨术可以作为脊髓栓系综合征的一种安全且可替代的手术技术。
