Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.
World Neurosurg. 2019 May;125:e1151-e1159. doi: 10.1016/j.wneu.2019.01.265. Epub 2019 Feb 18.
To compare bony spur resection (BR) with bony spur nonresection (BN) treatment in patients with congenital scoliosis and type I split cord malformation.
Patients with congenital scoliosis and type I split cord malformation who underwent corrective surgery in a single institution from 2008 to 2015 were retrospectively evaluated. Patients were divided into 2 groups according to whether BR was performed or not: the BR group included 12 patients, and the BN group included 20 patients. Complications and perioperative and radiographic data were recorded and compared.
The study included 32 patients. Mean age at surgery was 14.3 years, and average follow-up period was 2.8 years. There were no statistically significant differences in correction rate of the major curve or other radiographic parameters at final follow-up. Preoperative concerns (6.8 vs. 5.8, P = 0.006), operative times (508.5 minutes vs. 311.3 minutes, P = 0.009), blood loss (1433.3 mL vs. 1015.8 mL, P = 0.064), and hospital charges ($22,387.80 vs. $15,706.8, P = 0.032) were lower in the BN group than in the BR group. Total and major complication rates were higher in the BR group than in the BN group, even though there were no statistically significant differences (58.3% vs. 30.0% and 8.3% vs. 5.0%, respectively).
In patients with congenital scoliosis and type I split cord malformation, not resecting the bony spur can achieve satisfactory radiographic and clinical outcomes with potentially fewer complications.
比较骨嵴切除术（BR）与骨嵴非切除术（BN）治疗先天性脊柱侧凸伴Ⅰ型脊髓纵裂的疗效。
回顾性分析 2008 年至 2015 年在单家医院接受矫形手术的先天性脊柱侧凸伴Ⅰ型脊髓纵裂患者。根据是否行 BR 将患者分为 BR 组（12 例）和 BN 组（20 例）。记录并比较两组患者的并发症及围手术期和影像学资料。
共纳入 32 例患者。手术时的平均年龄为 14.3 岁，平均随访时间为 2.8 年。末次随访时，两组患者的主弯矫正率及其他影像学参数均无统计学差异。术前顾虑（6.8 分比 5.8 分，P=0.006）、手术时间（508.5 分钟比 311.3 分钟，P=0.009）、出血量（1433.3 毫升比 1015.8 毫升，P=0.064）和住院费用（22387.80 美元比 15706.80 美元，P=0.032）方面，BN 组均优于 BR 组。BR 组的总并发症和主要并发症发生率均高于 BN 组，但差异无统计学意义（58.3%比 30.0%和 8.3%比 5.0%）。
对于先天性脊柱侧凸伴Ⅰ型脊髓纵裂患者，不切除骨嵴可获得满意的影像学和临床结果，且潜在并发症更少。
