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脊髓脊膜膨出伴脊柱后凸:疾病的自然史和一种新手术技术的初步结果。

Myelomeningocele and Kyphosis: Natural History of the Disease and the First Results of a New Surgical Technique.

机构信息

Selcuk University, Faculty of Medicine Department of Neurosurgery, Konya,Turkey.

出版信息

Turk Neurosurg. 2021;31(2):274-281. doi: 10.5137/1019-5149.JTN.32341-20.2.

Abstract

AIM

To define the natural course of kyphosis, and to evaluate the efficiency of a new technique in surgical correction of kyphosis seen in myelomeningocele(MM) patients.

MATERIAL AND METHODS

We retrospectively reviewed our patients with MM. The rate of kyphosis, mean angle of progression and mean angle of surgical correction were evaluated. Surgical correction was achieved with the same technique in all patients; kyphectomy, short segment instrumentation with plate system and long segment instrumentation with screw-rod system.

RESULTS

A total of 14 patients were treated surgically and the mean age at the surgery was 39 months. The incidence of kyphosis rate was %21 in this study. The mean angle of kyphosis was 85.8°. Average angle of progression was 15.7° whereas it was 6.3° degree in patients whose kyphosis angle ?90 and > 90 degree, respectively, at birth. 14 patients were treated surgically and the mean age at the surgery was 39 months. The mean angle of correction of kyphosis was 86 degree. The most common complications were wound dehiscence and cerebro-spinal fluid leak. One patient died 3 months after surgery, and one patient was reoperated due to pull-out of screws.

CONCLUSION

Effective surgical correction of kyphosis in MM patients can be achieved with the described surgical technique even in younger ages. Prospective studies in larger study population are necessary for more accurate definition of natural history of kyphosis in MM patients.

摘要

目的

定义脊柱后凸的自然病程,并评估一种新的技术在治疗脊髓脊膜膨出(MM)患者脊柱后凸中的疗效。

材料与方法

我们回顾性分析了患有 MM 的患者。评估了脊柱后凸的发生率、进展角度的平均值和手术矫正角度的平均值。所有患者均采用相同的技术进行手术矫正:脊柱后凸切除术、短节段器械固定结合钢板系统和长节段器械固定结合钉棒系统。

结果

共有 14 例患者接受了手术治疗,手术时的平均年龄为 39 个月。本研究中脊柱后凸发生率为 21%。脊柱后凸的平均角度为 85.8°。进展角度的平均值为 15.7°,而出生时脊柱后凸角度为 90°和>90°的患者分别为 6.3°和 15.7°。14 例患者接受了手术治疗,手术时的平均年龄为 39 个月。脊柱后凸矫正的平均角度为 86°。最常见的并发症是切口裂开和脑脊液漏。1 例患者术后 3 个月死亡,1 例患者因螺钉拔出而再次手术。

结论

即使在年龄较小的患者中,采用描述的手术技术也可以有效矫正 MM 患者的脊柱后凸。需要在更大的患者群体中进行前瞻性研究,以更准确地定义 MM 患者脊柱后凸的自然病程。

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