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马凡综合征患者脊柱侧凸的手术治疗效果。

Surgical outcome of scoliosis in patients with Marfan syndrome.

机构信息

Division of Spine Surgery, Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

出版信息

Spine Deform. 2022 Nov;10(6):1453-1460. doi: 10.1007/s43390-022-00547-z. Epub 2022 Jul 30.

Abstract

PURPOSE

To evaluate clinical and radiographic outcomes after surgical scoliosis correction and posterior instrumented fusion in SMF patients.

METHODS

A single-center medical database was reviewed to identify MF patients who presented with scoliosis from 2000 to 2015. Patients who underwent spinal fusion surgery were included. Demographic, operative and clinical data were reviewed, and the preoperative, postoperative, and latest follow-up radiographic parameters were compared.

RESULTS

Twelve patients were identified (2 males, 10 females) with an average age at surgery of 14.4 ± 2.6 years. Comorbidities were found in 84.6%. Most patients (90.9%) presented with a right thoracic curve. The average preoperative Cobb angle was 75.6 ± 15.5 degrees. Posterior instrumented spinal fusion was performed in all patients (1 hook/pedicular screw and 11 pedicle screws only). The average follow-up period was 6.8 ± 3.1 years. The mean postoperative Cobb angle after surgery and at the final follow-up was 33.4 ± 18.0 degrees and 35.5 ± 18.4 degrees, respectively. There was a statistically significant difference among the preoperative and postoperative Cobb angles (p < 0.001), but no significant difference among the sagittal angles. Two perioperative complications including superficial wound infection and broken rods were observed.

CONCLUSIONS

Posterior scoliosis correction and instrumented spinal fusion resulted in a satisfactory outcome in MF patients. Perioperative complications are not uncommon; however, no neurological complication or spinal decompensation was observed in this study.

LEVEL OF EVIDENCE

IV.

摘要

目的

评估 SMF 患者后路脊柱侧凸矫正和器械融合术后的临床和影像学结果。

方法

回顾单中心医学数据库,以确定 2000 年至 2015 年期间出现脊柱侧凸的 MF 患者。纳入接受脊柱融合手术的患者。回顾了人口统计学、手术和临床数据,并比较了术前、术后和最新随访的影像学参数。

结果

共确定了 12 名患者(2 名男性,10 名女性),手术时的平均年龄为 14.4±2.6 岁。90.9%的患者存在合并症。大多数患者(90.9%)表现为右胸弯。术前 Cobb 角平均为 75.6±15.5 度。所有患者均行后路器械融合(1 个钩/椎弓根螺钉和 11 个椎弓根螺钉)。平均随访时间为 6.8±3.1 年。术后和末次随访时的平均 Cobb 角分别为 33.4±18.0 度和 35.5±18.4 度。术前和术后 Cobb 角之间存在统计学显著差异(p<0.001),但矢状面角度之间无显著差异。观察到 2 例围手术期并发症,包括浅表伤口感染和断棒。

结论

后路脊柱侧凸矫正和器械融合在 MF 患者中取得了满意的结果。围手术期并发症并不少见;然而,本研究未观察到神经并发症或脊柱失代偿。

证据水平

IV。

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