Department of Pediatric Orthopaedic Surgery, Timone Children Hospital, University of Marseille, Marseille, France.
Spine (Phila Pa 1976). 2011 Mar 15;36(6):E423-8. doi: 10.1097/BRS.0b013e31820e629e.
In a retrospective study, we report on 16 patients with congenital kyphosis due to progressively ossifying anterior unsegmented bars.
To specify the therapeutic strategy in such malformation.
Congenital kyphosis due to progressively ossifying anterior unsegmented bars is a particular and uncommon entity of congenital kyphosis. Progressive anterior vertebral bars result in slowly progressive kyphosis, which rarely lead to neurological compromise. Sagittal equilibrium of the spine is maintained by compensatory curves adjacent to the primary curve.
All patients had clinical assessment and successive measurements of segmental angle made on a standing lateral radiograph of the spine. Magnetic resonance imaging was obtained in four patients. Six patients were just observed. A brace was used in three. And seven were treated surgically.
The compensatory capacity of the spine is reduced in lumbar area where there are few discs spaces below the bar. Presentation therefore tends to be at an earlier age and pain is more common.Magnetic resonance imaging enables definition of the structures immediately posterior to the bar and provides information regarding the integrity of the intervertebral disc.
There is usually no need for surgery in thoracic and thoracolumbar localization. In lumbar localization, if the diagnosis is done early in childhood and if magnetic resonance imaging shows beyond the anterior ossification a normal T2-weighted magnetic resonance imaging disc space signal, desepiphysiodesis bar resection and cement interposition is mandatory. If the disc magnetic resonance imaging signal is abnormal or if the disc space is totally ossified, we propose a surgical correction of the kyphosis. For such cases a posterior wedge osteotomy seems to be the more suitable procedure.
在一项回顾性研究中，我们报告了 16 例先天性脊柱后凸畸形患者，这些患者的病因是逐渐骨化的节段性前未分节的骨条。
明确此类畸形的治疗策略。
先天性脊柱后凸畸形伴逐渐骨化的节段性前未分节骨条是一种特殊且罕见的先天性脊柱后凸畸形。进展性前椎体骨条导致进行性脊柱后凸，很少导致神经功能受损。脊柱矢状位平衡由原发曲度相邻的代偿性曲度维持。
所有患者均进行临床评估，并在站立位脊柱侧位片上进行节段性角度的连续测量。4 例患者行磁共振成像检查。6 例仅进行观察。3 例患者使用支具。7 例患者接受手术治疗。
在存在骨条下方很少椎间盘间隙的腰椎区域，脊柱的代偿能力降低。因此，病变表现趋于更早发生，疼痛更为常见。磁共振成像可以明确骨条后方的结构，并提供有关椎间盘完整性的信息。
在胸段和胸腰段，通常不需要手术治疗。在腰椎部位，如果在儿童期早期诊断，且磁共振成像显示骨化前的结构正常（T2 加权磁共振成像椎间盘信号正常），则需要进行骺板切除术和骨水泥植入。如果椎间盘磁共振成像信号异常或椎间盘完全骨化，则建议进行脊柱后凸畸形的手术矫正。对于此类病例，后路楔形截骨术似乎是更合适的术式。
