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吉兰-巴雷综合征继发脊柱侧弯的成功手术治疗:病例报告

Successful surgical treatment of scoliosis secondary to Guillain-Barré syndrome: Case report.

作者信息

Li Zheng, Shen Jianxiong, Liang Jinqian, Feng Fan

机构信息

Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Medicine (Baltimore). 2016 Jun;95(26):e3775. doi: 10.1097/MD.0000000000003775.

Abstract

Guillain-Barré syndrome (GBS) is an acute autoimmune inflammatory demyelinating polyneuropathy that mostly affects the peripheral nervous system. Little is reported about spinal deformity associated with GBS. This study aims to present a case of scoliosis occurring in the setting of GBS.Case report and literature review.The patient was a 14-year-old male with scoliosis. His spinal plain radiographs showed that the Cobb angle of thoracic scoliosis was 114°. History review revealed that he developed profound lower extremity pain, weakness, and numbness after catching a cold 5 years ago. These symptoms progressed to unsteady gait and inability to stand up from squatting position. The diagnosis of GBS was confirmed based on these symptoms. He underwent a posterior correction at Thoracic 5-Lumbar 5 (T5-L12) levels using the (LEGACY, USA) spinal system. The Cobb angle was corrected from 114° to 45° (correction rate 60.5%). His follow-up was symptomatic, well balanced in the coronal planes, with solid fusion 12 months after the operation.Neuromuscular scoliosis could develop secondary to GBS. When evaluating patients with acute inflammatory polyneuropathy, clinical examination of the spine is essential to identify patients with rare neuromuscular scoliosis.

摘要

吉兰 - 巴雷综合征(GBS)是一种急性自身免疫性炎性脱髓鞘性多发性神经病,主要影响周围神经系统。关于与GBS相关的脊柱畸形报道较少。本研究旨在介绍1例发生于GBS背景下的脊柱侧凸病例。病例报告及文献综述。该患者为一名14岁患有脊柱侧凸的男性。其脊柱X线平片显示胸段脊柱侧凸的Cobb角为114°。病史回顾发现,他在5年前感冒后出现严重的下肢疼痛、无力和麻木。这些症状进展为步态不稳以及无法从蹲位站立。基于这些症状,GBS诊断得以确诊。他接受了使用(美国LEGACY)脊柱系统在胸5至腰5(T5 - L12)水平进行的后路矫正。Cobb角从114°矫正至45°(矫正率60.5%)。术后12个月随访时症状改善,冠状面平衡良好,融合牢固。神经肌肉型脊柱侧凸可继发于GBS。在评估急性炎性多发性神经病患者时,对脊柱进行临床检查对于识别罕见的神经肌肉型脊柱侧凸患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ac/4937895/434a3e7e1497/medi-95-e3775-g001.jpg

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