Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Orthopedics, Çubuk Halil Şıvgın State Hospital, Ankara, Turkey.
Br J Neurosurg. 2024 Oct;38(5):1114-1119. doi: 10.1080/02688697.2022.2034741. Epub 2022 Feb 8.
Sagittal imbalance is common in degenerative and congenital spinal diseases. Some studies have examined spinal deformities in the spina bifida. However, sagittal spinopelvic parameters in tethered cord syndrome (TCS) and split cord malformation (SCM) have been poorly evaluated in the literature. In this study, we investigated sagittal spinopelvic differences in TCS due to fatty filum terminale and SCM patients.
A total of 78 patients with spina bifida occulta (30 SCM and 48 TCS due to fatty filum terminale) were included in the study. Radiological images of these patients were retrospectively evaluated. We evaluated the pelvic incidence, pelvic tilt, sacral slope, sagittal vertical axis (SVA), T1 pelvic angle, lumbar lordosis (LL), thoracic kyphosis, thoracolumbar alignment, and change in those parameters with age.
Correlation coefficients between age and LL, T1 pelvic angle, and the SVA in patients with TCS due to fatty filum terminale were statistically significant. In addition, correlation coefficients between age and LL and the SVA in patients with SCM were statistically significant. Notably, LL was increased at a statistically significant level with age in patients with TCS and SCM.
Improved knowledge of spinal balance parameters in patients with TCS and SCM may be helpful in understanding the clinical course of these pathologies, and provide information regarding the success of surgery at the follow-up period.
矢状面失衡在退行性和先天性脊柱疾病中很常见。一些研究已经检查了脊膜膨出中的脊柱畸形。然而,在文献中,拴系综合征(TCS)和脊髓分裂畸形(SCM)患者的矢状位脊柱骨盆参数评估不足。在这项研究中,我们研究了终丝脂肪病所致 TCS 和 SCM 患者的矢状位脊柱骨盆差异。
共纳入 78 例隐性脊柱裂患者(30 例 SCM 和 48 例终丝脂肪病所致 TCS)。回顾性评估这些患者的影像学图像。我们评估了骨盆入射角、骨盆倾斜角、骶骨倾斜角、矢状垂直轴(SVA)、T1 骨盆角、腰椎前凸角、胸椎后凸角、胸腰椎对线以及这些参数随年龄的变化。
终丝脂肪病所致 TCS 患者的年龄与 LL、T1 骨盆角和 SVA 之间存在统计学显著的相关系数。此外,SCM 患者的年龄与 LL 和 SVA 之间也存在统计学显著的相关系数。值得注意的是,TCS 和 SCM 患者的 LL 随年龄增长呈统计学显著增加。
提高对 TCS 和 SCM 患者脊柱平衡参数的认识,可能有助于了解这些病理的临床过程,并为随访期间手术的成功提供信息。