Xue Xu-hong, Shen Jian-xiong, Liu Jia-ming, Zhang Jian-guo, Zhao Hong, Li Shu-gang, Zhao Yu, Zhao Li-juan, Wang Yi-peng, Qiu Gui-xing
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
Zhonghua Wai Ke Za Zhi. 2013 Aug;51(8):732-6.
To investigate the incidences and characteristics of the ribs and intraspinal abnormalities in surgical patients with congenital scoliosis.
We conducted a retrospective study of the medical records and spine radiographs of 118 patients underwent surgical treatment between January 2010 and March 2011 with congenital scoliosis. The average age was 14 years (3-50 years).Fifty-two were male and 66 were female patients. The rib and intraspinal abnormalities were compared in different vertebral anomalies. Pearson's χ(2) test were used to analyze the incidence of anomalies of the ribs and vertebrae, as well as intraspinal anomalies.
A total of 57 (48.3%) patients were found to have intraspinal abnormalities.Split cord deformities were identified to be the most common intraspinal anomaly (32.2%), followed by syringomyelia (21.2%).Sixty-nine patients (58.5%) had rib anomalies, which occurring on the concavity of the scoliosis was most frequent. The patients with mixed deformity and failure of segment were found to have a higher incidence of rib anomaly than those with failure formation (χ(2) = 14.05, P < 0.01). The patients with multiple level malformations were found to have significantly higher incidence of rib anomaly than those with single level malformation (χ(2) = 27.50, P < 0.01).Intraspinal anomalies occurred in 42 of 69 patients (60.9%) with rib anomalies and 15 of 49 patients (30.6%) without rib anomalies in congenital scoliosis. The occurrence of intraspinal malformation has significant difference with or without rib anomalies in congenital scoliosis (χ(2) = 10.5, P < 0.01).
The intraspinal malformation is common in patients with mixed defects and failures of segmentation. The rib anomalies occurring on the concavity of the scoliosis is most frequent. The incidence of intraspinal anomaly is significant higher in the patients with rib anomalies than those without rib anomalies. Both the occurrence and type of rib anomaly, combined with vertebral deformity are helpful in forecasting the occurrence of intraspinal abnormalis.
探讨先天性脊柱侧凸手术患者肋骨及椎管内异常的发生率及特征。
我们对2010年1月至2011年3月间接受先天性脊柱侧凸手术治疗的118例患者的病历和脊柱X线片进行了回顾性研究。平均年龄为14岁（3 - 50岁）。男性52例，女性66例。比较不同椎体异常情况下的肋骨及椎管内异常情况。采用Pearson卡方检验分析肋骨和椎体异常以及椎管内异常的发生率。
共发现57例（48.3%）患者存在椎管内异常。脊髓纵裂畸形被确定为最常见的椎管内异常（32.2%），其次是脊髓空洞症（21.2%）。69例（58.5%）患者有肋骨异常，其中发生在脊柱侧凸凹侧的最为常见。发现混合畸形和节段发育不良的患者肋骨异常发生率高于节段形成失败的患者（χ² = 14.05，P < 0.01）。多节段畸形患者的肋骨异常发生率显著高于单节段畸形患者（χ² = 27.50，P < 0.01）。先天性脊柱侧凸患者中，69例有肋骨异常的患者中有42例（60.9%）发生椎管内异常，49例无肋骨异常的患者中有15例（30.6%）发生椎管内异常。先天性脊柱侧凸患者有无肋骨异常时椎管内畸形的发生率有显著差异（χ² = 10.5，P < 0.01）。
椎管内畸形在混合性缺陷和节段发育不良的患者中很常见。发生在脊柱侧凸凹侧的肋骨异常最为常见。有肋骨异常的患者椎管内异常的发生率显著高于无肋骨异常的患者。肋骨异常的发生情况和类型，以及椎体畸形，有助于预测椎管内异常的发生。
