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[科芬-洛里综合征。其与先天性颈椎管狭窄和脊髓软化症的关联]

[Coffin-Lowry syndrome. Its association with congenitally narrow cervical canal and myelomalacia].

作者信息

García-Suárez Adrián, Dansac-Rivera Arie Benoit

机构信息

Servicio de Columna Ortopédica, Hospital de Ortopedia, Instituto Mexicano del Seguro Social, Distrito Federal, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2014 Nov-Dec;52(6):692-5.

Abstract

BACKGROUND

Typical clinical features of the Coffin-Lowry syndrome include facies with hypertelorism, small nose, wide mouth, full and everted lips; short stature, mental retardation, pectus deformity, mitral valve dysfunction, hippocampal and cerebellar involvement, hearing loss and spinal disorders such as kyphosis and scoliosis. Due to its scarce incidence, it is difficult making an early diagnosis. The aim of this report was to document the anatomical peculiarities identified during the surgical treatment of a patient with this syndrome.

CLINICAL CASE

Male patient with Coffin-Lowry syndrome who evolved with narrow cervical canal plus myelomalacia at short age, making decompression from C3 to C6 and instrumentation from C2 to C7 necessary. During the surgery, in addition to calcification of the yellow ligament, adhesions on the dura mater from C4 to C4, dark purplish color in this area and hourglass-shaped thinning were found; the ends at C3 and C6 were normal. The purpose of the surgery was to stop the myopathy. Post-operatively, the patient had pulmonary complications; at the sixth day he passed away due to ventilatory complications and inadequate secretion control.

CONCLUSIONS

The Coffin-Lowry syndrome is a rare diagnosis in our country; neurological involvement at the spinal level is characterized by kyphosis or scoliosis; for its diagnosis, an adequate medical history and a karyotype are necessary.

摘要

背景

科芬-洛里综合征的典型临床特征包括面部五官间距增宽、小鼻子、宽嘴巴、嘴唇丰满外翻;身材矮小、智力发育迟缓、胸廓畸形、二尖瓣功能障碍、海马体和小脑受累、听力丧失以及脊柱疾病,如脊柱后凸和脊柱侧凸。由于其发病率低,早期诊断困难。本报告的目的是记录一名患有该综合征患者手术治疗过程中发现的解剖学特征。

临床病例

一名患有科芬-洛里综合征的男性患者,在幼年时出现颈椎管狭窄并伴有脊髓软化,因此有必要进行从C3至C6的减压以及从C2至C7的内固定手术。手术过程中,除了发现黄韧带钙化外,还发现从C4至C4硬脑膜有粘连、该区域呈深紫色以及沙漏形变薄;C3和C6两端正常。手术目的是阻止肌病发展。术后,患者出现肺部并发症;第六天因通气并发症和分泌物控制不佳死亡。

结论

科芬-洛里综合征在我国是一种罕见的诊断;脊髓水平的神经受累以脊柱后凸或脊柱侧凸为特征;对于其诊断,需要详细的病史和染色体核型检查。

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