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一名4岁男孩髓内脊髓肿瘤切除术后手术性进行性颈椎后凸畸形的自发恢复:病例说明

Spontaneous recovery of postsurgical progressive cervical spine kyphosis following intramedullary spinal cord tumor resection in a 4-year-old boy: illustrative case.

作者信息

Michaud Eve, Bokhari Rakan, Saint-Martin Christine, Saran Neil, Dudley Roy W R

机构信息

Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada.

Division of Neurosurgery, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

J Neurosurg Case Lessons. 2024 Oct 28;8(18). doi: 10.3171/CASE24187.

Abstract

BACKGROUND

Postsurgical kyphosis is relatively common in children who have undergone resection of intramedullary spinal cord tumors. Progressive kyphosis almost always requires instrumentation and fusion surgery, which can delay or interfere with adjuvant oncological treatments and can deleteriously impact the long-term performance status of the patient.

OBSERVATIONS

Here, the authors report a case of near-complete spontaneous recovery (i.e., without spinal fusion surgery) of postsurgical progressive cervical spine kyphosis following intramedullary spinal cord tumor resection and discuss the potential factors that may have contributed to this positive outcome.

LESSONS

This case serves as a reminder that spontaneous recovery from postsurgical progressive cervical spine kyphosis can occur and that some patients (i.e., those without neurological deficits) can be monitored closely, with a watch-and-wait approach, before subjecting them to additional surgical risks, delays in other treatments, and potential morbidity. https://thejns.org/doi/10.3171/CASE24187.

摘要

背景

术后脊柱后凸在接受髓内脊髓肿瘤切除的儿童中相对常见。进行性脊柱后凸几乎总是需要器械固定和融合手术,这可能会延迟或干扰辅助肿瘤治疗,并可能对患者的长期功能状态产生不利影响。

观察结果

在此,作者报告了1例髓内脊髓肿瘤切除术后进行性颈椎后凸近乎完全自发恢复(即未进行脊柱融合手术)的病例,并讨论了可能促成这一良好结果的潜在因素。

经验教训

该病例提醒我们,术后进行性颈椎后凸可出现自发恢复,对于一些患者(即无神经功能缺损者),在使其承受额外手术风险、其他治疗延迟及潜在并发症之前,可密切观察并采用观察等待策略。https://thejns.org/doi/10.3171/CASE24187

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad5b/11525755/a23b51cb124f/CASE24187_figure_1.jpg

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