Coskun Ergin, Wellington Ian J, Chaudhary Chirag, Crea Kathleen, Cote Mark P, Rhee John M, Mallozzi Scott, Moss Isaac L, Singh Hardeep
Riley Hospital for Children, Indiana University Health, 705 Riley Hospital Dr, Indianapolis, IN 46202, United States.
Department of Orthopedics, The University of Connecticut, 120 Dowling Way, Farmington, CT 06032, United States.
N Am Spine Soc J. 2024 Apr 12;18:100324. doi: 10.1016/j.xnsj.2024.100324. eCollection 2024 Jun.
Chin-on-chest deformity is a rare and severely disabling condition characterized by kyphotic deformity in the cervicothoracic spine. To treat this deformity, various osteotomy techniques were described.
A comprehensive literature search of biomedical databases including MEDLINE (via PubMed), Scopus (via Elsevier), Embase (via Elsevier), and Cochrane Library in English from 1/1/1990 to 3/31/2022 was conducted using a combination of text and Medical Subject Headings (MeSH).
The final analysis included 16 studies. All the studies were assigned a level of evidence of four. Except for two articles, all of the articles were non-comparative studies. A total of 288 patients were included in this review. Of the 288 patients, 107 underwent posterior column extension osteotomy (PCEO), 108 underwent pedicle subtraction osteotomy (PSO), and 33 underwent vertebral column resection osteotomy (VCRO). The most common osteotomy level in fifteen of the studies was C7/T1. The studies included in this review described several techniques for cervical sagittal balance correction. The range of preoperative and postoperative visual analogue scale (VAS) scores was 5.5-8.6 to 1.7-4.91, respectively. The range of preoperative and postoperative neck disability index (NDI) was 34.2-65.4 to 22.1-51.3, respectively. The most common complications were upper extremity paresthesia and hand numbness through the C8 dermatome distribution.
Corrective osteotomies provide satisfactory results in patients with chin-on-chest deformity; however, the quality of the included studies limits the evidence.
低头胸畸形是一种罕见且严重致残的疾病，其特征为颈胸段脊柱后凸畸形。为治疗这种畸形，人们描述了多种截骨技术。
使用文本和医学主题词（MeSH）相结合的方式，对1990年1月1日至2022年3月31日期间的生物医学数据库进行全面的文献检索，这些数据库包括英文的MEDLINE（通过PubMed）、Scopus（通过Elsevier）、Embase（通过Elsevier）和Cochrane图书馆。
最终分析纳入了16项研究。所有研究的证据等级均为四级。除两篇文章外，其余均为非对照研究。本综述共纳入288例患者。在这288例患者中，107例行后路柱延长截骨术（PCEO），108例行椎弓根截骨术（PSO），33例行脊柱切除术（VCRO）。15项研究中最常见的截骨水平为C7/T1。本综述纳入的研究描述了几种颈椎矢状面平衡矫正技术。术前和术后视觉模拟量表（VAS）评分范围分别为5.5 - 8.6至1.7 - 4.91。术前和术后颈部功能障碍指数（NDI）范围分别为34.2 - 65.4至22.1 - 51.3。最常见的并发症是上肢感觉异常和通过C8皮节分布的手部麻木。
截骨矫正术在低头胸畸形患者中取得了满意的效果；然而，纳入研究的质量限制了证据。
