Greggi T, Lolli F, Di Silvestre M, Martikos K, Vommaro F, Maredi E, Giacomini S, Baioni A, Cioni A
Department of Spinal Deformity Surgery, Rizzoli Orthopaedic Institute, Bologna Italy.
Stud Health Technol Inform. 2012;176:315-8.
41 consecutive patients surgically treated at Our Department by posterior only instrumented fusion from January 1995 to January 2009 were reviewed. There were 20 females and 21 males with a mean age of 15.8 years (range, 10 to 38). Diagnosis was: cerebral palsy (13 cases), Duchenne muscular dystrophy (7), spinal amyotrophy (7), myelomeningocele (5), poliomyelitis (3), Friedreich's ataxia (2), Escobar syndrome (2), Steinert's disease (1), Charcot Marie Tooth disease (1). Main scoliosis Cobb angle averaged 94.05° (range, 34° to 165°), the curve was thoracic in 19 cases, thoracolumbar or lumbar in 22 cases. Kyphosis (T5-T12) averaged 42.86° (range, 7° to 90°), lordosis was 33.57°. The fusion was extended to the lumbar tract in 23 patients, to the sacrum in the other 18. Our results showed that, in patients with neuromuscular scoliosis, posterior instrumented fusion is a safe and effective procedure and is the treatment of choice for patients with limited respiratory function, as in Duchenne muscular dystrophy and spinal muscular atrophy. The surgery should be performed as early as possible, and the extension of the fusion to the sacrum should be avoided in patients with residual walking ability.
回顾了1995年1月至2009年1月在我科接受单纯后路器械融合手术治疗的41例连续患者。其中女性20例，男性21例，平均年龄15.8岁（范围10至38岁）。诊断包括：脑瘫（13例）、杜氏肌营养不良症（7例）、脊髓性肌萎缩症（7例）、脊髓脊膜膨出（5例）、小儿麻痹症（3例）、弗里德赖希共济失调（2例）、埃斯科巴综合征（2例）、斯坦纳特病（1例）、夏科-马里-图斯病（1例）。主要脊柱侧弯Cobb角平均为94.05°（范围34°至165°），其中19例为胸段侧弯，22例为胸腰段或腰段侧弯。后凸畸形（T5 - T12）平均为42.86°（范围7°至90°），前凸为33.57°。23例患者融合范围延伸至腰段，另外18例延伸至骶段。我们的结果表明，对于神经肌肉型脊柱侧弯患者，后路器械融合是一种安全有效的手术方法，是呼吸功能受限患者（如杜氏肌营养不良症和脊髓性肌萎缩症患者）的首选治疗方法。手术应尽早进行，对于仍有行走能力的患者应避免将融合范围延伸至骶段。
