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颈胸段脊柱重复畸形:对一名神经功能正常男孩的10年随访

Cervicothoracic spine duplication: a 10-year follow up of a neurological intact boy.

作者信息

Kaya Ozcan, Ulusoy Onur Levent, Karadereler Selhan, Hamzaoglu Azmi

机构信息

Istanbul Gelisim University, Istinye University Bahcesehir Liv Hospital, 34513, Avcilar-Esenyurt/Istanbul, Turkey.

Istanbul Spine Center, Istanbul Florence Nightingale Hospital, Sisli/Istanbul, Turkey.

出版信息

Eur Spine J. 2018 Jul;27(Suppl 3):489-493. doi: 10.1007/s00586-018-5524-1. Epub 2018 Feb 17.

Abstract

PURPOSE

Spine duplication is a very rare condition with the literature being composed of only case reports. All previously reported cases were thoracolumbar spine duplications. Here, we report cervicothoracic spine duplication in a neurological intact male. According to our knowledge, it is the first case in the literature of cervicothoracic spine duplication.

CLINICAL PRESENTATION

A 3-year-old patient presented to a primary physician with a complaint of short stature. He was referred to our department with suspected spinal deformity. Computerized tomography imaging revealed anterior bony structure duplication and posterior dysmorphic elements at the C5-T9 levels. Magnetic resonance imaging revealed a syrinx cavity which splits cord at the duplication level and the relation of the syrinx with posterior mediastinum through anterior bone defect. He was followed up for 10 years.

CONCLUSION

In the literature, spine duplication has been classified as a severe form of split cord malformation because of the concurrence of bone duplication with split spinal cord malformation (SCM). This case presents a distinct form of SCM which shows non-duplicated dural tube as unclassified and cervicothoracic duplication level without neurological deficitis. Treatment of SCM was based on removal of splitting fibrous/osseous process. Neurologic intact spine duplication could be followed up without surgical intervention.

摘要

目的

脊柱重复畸形是一种非常罕见的病症,文献中仅有病例报告。此前所有报道的病例均为胸腰椎脊柱重复畸形。在此,我们报告一例神经系统正常的男性患者出现颈胸段脊柱重复畸形。据我们所知,这是文献中首例颈胸段脊柱重复畸形病例。

临床表现

一名3岁患者因身材矮小就诊于初级医师处。他因疑似脊柱畸形被转诊至我们科室。计算机断层扫描成像显示C5 - T9水平存在前方骨结构重复及后方形态异常的结构。磁共振成像显示一个脊髓空洞,该空洞在重复水平处将脊髓分开,且通过前方骨缺损与后纵隔相连。对其进行了10年的随访。

结论

在文献中,由于骨重复畸形与脊髓纵裂畸形(SCM)同时存在,脊柱重复畸形被归类为脊髓纵裂畸形的一种严重形式。该病例呈现出一种独特的SCM形式,表现为未分类的无重复硬脊膜管以及无神经功能缺损的颈胸段重复水平。SCM的治疗基于切除分隔的纤维性/骨性结构。神经功能正常的脊柱重复畸形可在不进行手术干预的情况下进行随访。

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