脊柱不稳定肿瘤评分在识别需要脊柱手术的戈谢病患者中的应用。
Utility of the spinal instability neoplastic score to identify patients with Gorham-Stout disease requiring spine surgery.
作者信息
Gui Chloe, Rocos Brett, Lohkamp Laura-Nanna, Cheung Angela, Bleakney Robert, Massicotte Eric
机构信息
Department of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada.
Department of Medicine, University Health Network, Toronto, Ontario, Canada.
出版信息
Surg Neurol Int. 2021 May 17;12:227. doi: 10.25259/SNI_311_2021. eCollection 2021.
BACKGROUND
Gorham-Stout disease (GSD) is a rare syndrome presenting with progressive osteolysis which in the spine can lead to cord injury, instability, and deformity. Here, the early spine surgery may prevent catastrophic outcomes.
CASE DESCRIPTION
A 25-year-old male with GSD involving the T2 to T6 levels presented with acute traumatic kyphoscoliosis at T3 and T4 and left lower extremity paraparesis. The CT scan 4 weeks before this showed progressing osteolysis versus the CT 5 years ago. Unfortunately, the patient underwent delayed treatment resulting in permanent neurological sequelae. Surgery included a laminectomy and vertebrectomy of T3/T4 with instrumented fusion from T1-10. The use of the spinal instability neoplastic score (SINS) is a useful tool to prompt early referral to spine surgeons.
CONCLUSION
We recommend using the SINS score in GSD patients who develop spinal lesions to prompt early referral for consideration of surgery.
背景
戈勒姆-斯托特病（GSD）是一种罕见的综合征，表现为进行性骨质溶解，在脊柱中可导致脊髓损伤、不稳定和畸形。在此情况下，早期脊柱手术可预防灾难性后果。
病例描述
一名25岁男性，GSD累及T2至T6节段，出现T3和T4水平的急性创伤性脊柱侧凸和左下肢轻瘫。此次检查前4周的CT扫描显示骨质溶解进展，与5年前的CT相比。不幸的是，患者接受了延迟治疗，导致永久性神经后遗症。手术包括T3/T4椎板切除术和椎体切除术，并进行T1-10节段的器械融合。使用脊柱不稳定肿瘤评分（SINS）是促使早期转诊至脊柱外科医生的有用工具。
结论
我们建议在发生脊柱病变的GSD患者中使用SINS评分，以促使早期转诊考虑手术。
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