Zhang Tianyuan, Shu Shibin, Jing Wenting, Gu Qi, Liu Zhen, Sun Xu, Wang Bin, Qiu Yong, Zhu Zezhang, Bao Hongda
Department of Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Spine Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China.
Global Spine J. 2022 Jun;12(5):916-921. doi: 10.1177/2192568220970509. Epub 2020 Nov 18.
A retrospective study.
To identify if there is a link between sacral agenesis (SA) and post-operative coronal imbalance in patients with congenital lumbosacral deformities.
This study reviewed a consecutive series of patients with congenital lumbosacral deformities. They had a minimum follow-up of 2 years. According to different diagnosis, they were divided into SA and non-SA group. Comparison analysis was performed between patients with and without post-operative coronal imbalance and risk factors were identified.
A total of 45 patients (18 in SA group and 27 in non-SA group) were recruited into this study, among whom 33 patients maintained coronal balance while 12 demonstrated postoperative coronal imbalance at last follow-up (14.32 ± 7.67 mm vs 35.53 ± 3.91 mm, P < 0.001). Univariate analysis showed that preoperative lumbar Cobb angle, immediate postoperative coronal balance distance and diagnosis of SA were significantly different between patients with and without post-operative coronal imbalance (P < 0.05). Binary logistic regression analysis showed that SA was an independent risk factor for postoperative coronal imbalance.
As an independent risk factor for postoperative coronal imbalance, high level of suspicion of SA should be aware in children with congenital lumbosacral deformities. Sufficient bone grafts at sacroiliac joint are recommended for SA patients to prevent postoperative coronal imbalance.
一项回顾性研究。
确定先天性腰骶部畸形患者中骶骨发育不全（SA）与术后冠状面失衡之间是否存在关联。
本研究回顾了一系列连续性先天性腰骶部畸形患者。他们的随访时间至少为2年。根据不同诊断，将他们分为SA组和非SA组。对有和没有术后冠状面失衡的患者进行比较分析，并确定危险因素。
本研究共纳入45例患者（SA组18例，非SA组27例），其中33例患者维持冠状面平衡，12例在末次随访时出现术后冠状面失衡（14.32±7.67mm对35.53±3.91mm，P<0.001）。单因素分析显示，术前腰椎Cobb角、术后即刻冠状面平衡距离和SA诊断在有和没有术后冠状面失衡的患者之间存在显著差异（P<0.05）。二元逻辑回归分析显示，SA是术后冠状面失衡的独立危险因素。
作为术后冠状面失衡的独立危险因素，对于先天性腰骶部畸形儿童应高度怀疑SA。建议对SA患者在骶髂关节处进行充分的植骨以预防术后冠状面失衡。
