面肩肱型肌营养不良症中腰椎前凸的手术矫正：一例报告。
Surgical correction of hyperlordosis in facioscapulohumeral muscular dystrophy: A case report.
作者信息
Tan Haining, Feng Fan, Lin Youxi, Chen Chong, Li Zheng, Shen Jianxiong
机构信息
Department of Orthopedics, Peking Union Medical College Hospital and Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
出版信息
BMC Surg. 2017 Jul 17;17(1):83. doi: 10.1186/s12893-017-0276-0.
BACKGROUND
Hyperlordosis is common in facioscapulohumeral muscular dystrophy (FSHD), which cannot be controlled by bracing. While the surgical treatment is neither reported nor recommended in previous studies, we report the first corrective surgery for hyperlordosis in one wheelchair-dependent FSHD patient.
CASE PRESENTATION
A 15-year-old, wheelchair-dependent girl complaining of hyperlordosis and lower extremity weakness was diagnosed as FSHD. Preoperative examination showed hyperlordosis of 116° with scoliosis of 44°. Posterior correction and bone graft fusion was performed. Postoperatively, the hyperlordosis was corrected to 72° and better sitting posture was gotten. 12 months' follow-up showed favorable correction with improvement in SF-36 and ODI score.
CONCLUSIONS
The correction for hyperlordosis in FSHD is controversial. We report the first successful case of operative treatment by corrective spine surgery in these rare and demanding patient collective. Corrective surgery for spinal deformity, such as hyperlordosis and scoliosis, could do some help in posture and improve the quality of life especially in wheelchair-dependent patients.
背景
腰椎前凸在面肩肱型肌营养不良症（FSHD）中很常见，支具无法控制这种情况。虽然先前的研究既未报道也未推荐手术治疗，但我们报告了首例针对一名依赖轮椅的FSHD患者的腰椎前凸矫正手术。
病例介绍
一名15岁、依赖轮椅的女孩，主诉腰椎前凸和下肢无力，被诊断为FSHD。术前检查显示腰椎前凸116°，伴有脊柱侧弯44°。进行了后路矫正和植骨融合术。术后，腰椎前凸矫正至72°，坐姿得到改善。12个月的随访显示矫正效果良好，SF-36和ODI评分有所改善。
结论
FSHD中腰椎前凸的矫正存在争议。我们报告了首例在这些罕见且要求苛刻的患者群体中通过脊柱矫正手术成功进行手术治疗的病例。脊柱畸形（如腰椎前凸和脊柱侧弯）的矫正手术对姿势有一定帮助，并能改善生活质量，尤其是对于依赖轮椅的患者。
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