Bhandutia Amit K, Nangunoori Raj, Whiting Donald M, Sangimino Mark J
Departments of Orthopaedic Surgery (A.K.B. and M.J.S.) and Neurological Surgery (R.N. and D.M.W.), Allegheny General Hospital, Pittsburgh, Pennsylvania.
JBJS Case Connect. 2017 Jul-Sep;7(3):e47. doi: 10.2106/JBJS.CC.16.00193.
An adolescent girl presented with an atypical scoliotic curve, pelvic obliquity, back pain, and lower-extremity paresthesias. A workup revealed generalized primary torsion dystonia. The condition was refractory to medical treatment and necessitated implantation of a deep brain stimulator. The scoliosis required operative correction, and the patient underwent posterior spinal arthrodesis with hook-rod instrumentation, which resulted in successful correction through 7 years of follow-up.
The differential diagnosis for adolescent scoliosis should include dystonia as a potential cause, especially when a patient presents with muscular contractures, an atypical scoliotic curve, pelvic obliquity, or changing curve characteristics.
一名青春期女孩出现非典型脊柱侧弯、骨盆倾斜、背痛和下肢感觉异常。检查发现为全身性原发性扭转性肌张力障碍。该病症对药物治疗无效,需要植入脑深部刺激器。脊柱侧弯需要手术矫正,患者接受了后路脊柱融合术并使用钩棒器械固定,经过7年的随访,矫正成功。
青少年脊柱侧弯的鉴别诊断应包括肌张力障碍作为潜在病因,特别是当患者出现肌肉挛缩、非典型脊柱侧弯曲线、骨盆倾斜或曲线特征变化时。