Sergeenko Olga M, Savin Dmitry M, Gabrielyan Anastacia, Arestova Yulia S, Ryabykh Sergey O, Burtsev Alexander V, Evsyukov Alexey V
Division of Spinal Surgery, Ilizarov Center, Kurgan, Russia.
Pirogov's Russian National Medical University, Moscow, Russia.
Spine Deform. 2025 Jan;13(1):211-219. doi: 10.1007/s43390-024-00968-y. Epub 2024 Sep 16.
The aim of this study is to evaluate and compare techniques and outcomes associated with two different technique of pelvic screw insertion in patients with caudal spine absence.
A cohort of patients with varying degrees of caudal structural regression, serves as the focal point of this investigation. Pelvic configurations were classified based on established criteria to facilitate comparative analysis. Each patient underwent spinal surgical interventions, with a follow-up period extending beyond 2 years. The primary surgical interventions predominantly involved spinal stabilization coupled with correction of scoliosis and kyphosis through one or two pairs of pelvic screws.
In this study, we investigated a cohort of 22 patients with caudal spine absence, encompassing diverse conditions, such as lumbo-sacral aplasia, hemisacrum, and lumbar absence, with preserved sacrum. Following spinal surgery, notable improvements were observed in scoliosis and pathological lumbar kyphosis, with several patients achieving significant functional milestones such as independent ambulation. There were no significant differences in short-term complications between patients undergoing single versus double pair pelvic screw implantation. Long-term complications, primarily non-fusion, were notably more prevalent in patients undergoing fixation with a single pair of pelvic screws.
Surgical intervention, particularly spinopelvic fixation, demonstrated promising outcomes in terms of improving spinal deformities. The implantation of two pairs of pelvic screws demonstrates greater reliability compared to the insertion of a single pair, diminishing the risk of non-fusion.
本研究旨在评估和比较尾椎缺失患者两种不同骨盆螺钉置入技术及其结果。
一组不同程度尾椎结构退变的患者作为本研究重点。根据既定标准对骨盆形态进行分类以利于比较分析。每位患者均接受脊柱外科手术干预，随访期超过2年。主要手术干预主要包括脊柱稳定术，通过一对或两对骨盆螺钉纠正脊柱侧凸和后凸。
本研究中，我们调查了22例尾椎缺失患者，包括多种情况，如腰骶部发育不全、半骶骨及腰椎缺失但骶骨保留。脊柱手术后，脊柱侧凸和病理性腰椎后凸有显著改善，部分患者实现了独立行走等重要功能里程碑。单对与双对骨盆螺钉植入患者的短期并发症无显著差异。长期并发症主要为不融合，在单对骨盆螺钉固定患者中更为常见。
手术干预，尤其是脊柱骨盆固定术，在改善脊柱畸形方面显示出良好结果。与单对骨盆螺钉置入相比，双对骨盆螺钉植入显示出更高的可靠性，降低了不融合风险。
