Chen Zhi-Jun, Qiu Yong, Sun Xu, Ma Wei-Wei
Spine Surgery, Affiliated Drum Tower Hospital of Medical School, Nanjing University, Nanjing 210008, China.
Zhonghua Wai Ke Za Zhi. 2009 Jun 1;47(11):829-32.
To investigate the abnormality of position of the cerebellar tonsil and somatosensory evoked potentials (SEP) in adolescent idiopathic scoliosis (AIS), and to explore its clinical significance.
Sagittal magnetic resonance imaging (MRI) of hindbrain and posterior tibial nerve SEP (PTN-SEP) were performed on 171 young operative treated AIS patients. The PTN-SEP obtained from 45 age-matched healthy control individuals were considered as standard values. Tonsillar ectopia (TE) was defined as any inferior displacement of the tonsils. Absence of SEP waveforms, prolongation of peek latency or asymmetrical peek latency were defined as pathological change. The incidence of TE and pathological SEP was determined in all AIS patients. The association of TE and abnormal SEP for AIS patients was also assessed.
The incidence of TE and abnormal SEP in AIS patients was 36.8% (63/171) and 36.3% (62/171), respectively. It was shown the frequency of TE and abnormal SEP were not significantly different among AIS patients with different curve severity. Statistical analysis failed to show a correlation between TE and abnormal SEP.
TE and disorder of somatosensory pathways do exist in a subgroup of AIS patients. However, there is not a significant association between TE and abnormal somatosensory function. It is suggested that TE and disorder of somatosensory function might contributes to different etiopathogenesis of AIS.
探讨青少年特发性脊柱侧凸(AIS)患者小脑扁桃体位置及体感诱发电位(SEP)的异常情况,并探讨其临床意义。
对171例接受手术治疗的年轻AIS患者进行后脑矢状面磁共振成像(MRI)及胫后神经SEP(PTN-SEP)检查。将45例年龄匹配的健康对照者的PTN-SEP作为标准值。扁桃体异位(TE)定义为扁桃体的任何向下移位。SEP波形缺失、峰潜伏期延长或峰潜伏期不对称定义为病理改变。测定所有AIS患者的TE和病理性SEP的发生率。还评估了AIS患者中TE与异常SEP的相关性。
AIS患者中TE和异常SEP的发生率分别为36.8%(63/171)和36.3%(62/171)。结果显示,不同曲线严重程度的AIS患者中TE和异常SEP的频率无显著差异。统计分析未显示TE与异常SEP之间存在相关性。
AIS患者亚组中确实存在TE和体感通路障碍。然而,TE与体感功能异常之间没有显著关联。提示TE和体感功能障碍可能促成了AIS不同的发病机制。