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尾椎退化综合征患儿脊柱骨盆不稳定的手术矫正

Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome.

作者信息

Vissarionov Sergei, Schroder Josh E, Kokushin Dmitrii, Murashko Vladislav, Belianchikov Sergei, Kaplan Leon

机构信息

The Turner Research Institute for Children's Orthopedics, St. Petersburg, Russia.

These authors contributed equally to this work.

出版信息

Global Spine J. 2019 May;9(3):260-265. doi: 10.1177/2192568218779984. Epub 2018 Jun 10.

Abstract

STUDY DESIGN

Retrospective cohort.

OBJECTIVE

To analyze the outcome of surgical correction of children with caudal regression syndrome.

METHODS

The study included 12 patients aged 1.5 to 9 years with caudal regression syndrome. In order determine the type of caudal regression, the Renshaw Classification was used. The surgery included correction and stabilization of the kyphotic deformity at the unstable lumbosacral region, with reconstruction of the sagittal balance using a bony block constructed from allograft. Short- and long-term outcomes were evaluated. The study was approved by the local institutional review board.

RESULTS

Children with types III and IV caudal regression syndrome underwent spinal-pelvic fusion, with 100% fusion rate, which allows sufficient stabilization of the lumbopelvic segment permitting patient mobilization and standing in type III patients. There were 5 complications needing additional care.

CONCLUSION

Multilevel pedicular screw fixation in combination with spinopelvic fusion with cortical allografts allows reconstruction of the sagittal alignment with solid bony fusion improving the quality of life for these patients.

摘要

研究设计

回顾性队列研究。

目的

分析尾椎退化综合征患儿手术矫正的结果。

方法

该研究纳入了12例年龄在1.5至9岁的尾椎退化综合征患儿。为确定尾椎退化的类型,采用了伦肖分类法。手术包括矫正和稳定不稳定腰骶部区域的后凸畸形,使用同种异体骨构建的骨块重建矢状面平衡。评估了短期和长期结果。该研究获得了当地机构审查委员会的批准。

结果

III型和IV型尾椎退化综合征患儿接受了脊柱-骨盆融合术,融合率达100%,这使得腰骶段得到充分稳定,III型患儿能够活动和站立。有5例并发症需要额外护理。

结论

多级椎弓根螺钉固定联合同种异体皮质骨脊柱-骨盆融合术可实现矢状面排列的重建,并实现坚固的骨融合,改善这些患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fe/6542167/84b57afdf5a4/10.1177_2192568218779984-fig1.jpg

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