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中国家族性腰椎休曼病合并特发性脊柱侧凸:首例报告

Familial lumbar Scheuermann disease with idiopathic scoliosis in China: First case report.

作者信息

Dai Yuliang, Li Yawei, Li Pengzhi, Li Lei, Tu Zhiming, Wang Bing

机构信息

Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(25):e7100. doi: 10.1097/MD.0000000000007100.

Abstract

RATIONALE

Given that Scheuermann disease rarely occurs in the lumbar region and that the co-occurrence of Scheuermann disease and idiopathic scoliosis (IS) has not been reported-the etiology of Scheuermann disease and IS is not clear. In this case report, we present familaiar lumbar Scheuermann disease with IS, in a Chinese proband, who was successfully treated with surgery.

PATIENT CONCERNS

A 16-year-old boy presented at the Second XiangYa Hospital of Central South University with a chief complaint of kyphotic deformity in the lower back for 4 years and obvious lower back pain. In addition, he complained of limited lumbar activity. And The proband's family history was obtained by routine inquiring. In this Chinese family with 17 members over 3 generations. The 3 patients (proband, proband's sister and father) shared the characteristics of vertebral wedging from L1 to L3 and a kyphosis Cobb angle of 37°, 70°, or 73°, respectively. The main deformity of the proband's mother was at T7-L1 with a Cobb angle of 102° in the coronal plane at T7-L1, thoracic kyphosis of 73°, and lumbar lordosis of 62°.

DIAGNOSES

Scheuermann's disease.

INTERVENTIONS

Clinical history, physical examination, laboratory tests, and radiographs of those in the pedigree were recorded, and the related literature was reviewed. The proband accepted osteotomy and orthopedic surgery for treatment.

OUTCOMES

After 3 months of treatment, postoperative lateral radiographs showed a significantly improved sagittal vertical axis (SVA). The other patients were continued to be seen in follow-up visits.

LESSONS

This series of lumbar Scheuermann patients with IS in a pedigree support the genetic contribution to Scheuermann disease. Therefore, this study provides some insight into the genetic etiology of Scheuermann disease with IS.

摘要

理论依据

鉴于休曼病很少发生在腰椎区域,且尚未有休曼病与特发性脊柱侧凸(IS)同时出现的报道——休曼病和IS的病因尚不清楚。在本病例报告中,我们介绍了一名患有IS的中国先证者家族性腰椎休曼病,该患者通过手术成功治愈。

患者情况

一名16岁男孩因下背部后凸畸形4年且伴有明显下背部疼痛就诊于中南大学湘雅二医院。此外,他还抱怨腰椎活动受限。通过常规询问获取了先证者的家族史。在这个三代共17人的中国家族中。3名患者(先证者、先证者的姐姐和父亲)均有L1至L3椎体楔形变,后凸Cobb角分别为37°、70°或73°。先证者母亲的主要畸形位于T7-L1,T7-L1冠状面Cobb角为102°,胸椎后凸73°,腰椎前凸62°。

诊断

休曼病。

干预措施

记录了家系中成员的临床病史、体格检查、实验室检查和X线片,并查阅了相关文献。先证者接受了截骨矫形手术治疗。

结果

治疗3个月后,术后侧位X线片显示矢状垂直轴(SVA)明显改善。其他患者继续接受随访。

经验教训

该家系中这一系列患有IS的腰椎休曼病患者支持了遗传因素对休曼病的影响。因此,本研究为患有IS的休曼病的遗传病因提供了一些见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f51/5484193/c44998590491/medi-96-e7100-g001.jpg

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