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脑瘫所致颈椎畸形的手术策略及围手术期注意事项:文献综述

Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature.

作者信息

Kim Hyung Cheol, Oh Sung Han, Oh Jae Keun, Ha Yoon

机构信息

Department of Neurosurgery, Bundang Jesaeng General Hospital, Seongnam, Korea.

Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.

出版信息

Neurospine. 2022 Dec;19(4):868-875. doi: 10.14245/ns.2244956.478. Epub 2022 Dec 31.

Abstract

The complex nature of the cervical spine makes surgical intervention challenging when treating cervical deformity in patients with cerebral palsy (CDCP). However, few studies have investigated the unique characteristics of cerebral palsy that create the need for surgery, the most effective surgical strategies, and the possible perioperative complications. The intended benefit and the potential risk of postoperative complications must be considered when deciding to operate for CDCP. Because the approach and correction strategy depend on the type of cervical deformity, as well as the patient's comorbidities and functional status, a customized strategy is needed. Perioperatively, botulinum toxin injections and muscle division techniques can help control excessive involuntary movements and improve the spinal fusion success rate. Surgical intervention for CDCP requires a multidisciplinary approach, and the information presented in this article is intended to help in the perioperative management and surgical treatment of CDCP.

摘要

颈椎的复杂结构使得在治疗脑瘫合并颈椎畸形(CDCP)患者时进行手术干预具有挑战性。然而,很少有研究调查导致手术需求的脑瘫独特特征、最有效的手术策略以及可能的围手术期并发症。在决定对CDCP进行手术时,必须考虑预期益处和术后并发症的潜在风险。由于手术入路和矫正策略取决于颈椎畸形的类型以及患者的合并症和功能状态,因此需要定制策略。在围手术期,肉毒杆菌毒素注射和肌肉分离技术有助于控制过度的不自主运动并提高脊柱融合成功率。CDCP的手术干预需要多学科方法,本文提供的信息旨在帮助进行CDCP的围手术期管理和手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c305/9816591/a8ee1d7c9453/ns-2244956-478f1.jpg

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