Tanida Shimei
Spine Surgery, Shiga General Hospital, Shiga, JPN.
Cureus. 2024 Oct 17;16(10):e71743. doi: 10.7759/cureus.71743. eCollection 2024 Oct.
There are few reports of syndromic scoliosis accompanied by a congenital vertebral anomaly. We report a case of Sotos syndrome with a concomitant congenital wedged vertebra whose kyphoscoliosis progressed rapidly and presented with myelopathy during the growth-spurt period. A 12-year-old male suffering from Sotos syndrome with T10-wedged vertebra presented with paraparesis and urinary dysfunction. Magnetic resonance imaging showed that the spinal cord was deviated to the concave side and was compressed from the right pedicle and posterior wall of the vertebral body at T10 level. He underwent direct decompression surgery including posterior right T10 pediculectomy and corrective fixation from T5 to L1. After the surgery, his gait disturbance improved, and he no longer had urinary incontinence. His kyphoscoliosis also improved. Two congenital diseases, Sotos syndrome and congenital vertebral anomaly, such as in the present case, require careful follow-up or early surgical intervention, especially during the growth-spurt period, to avoid missing the good timing for surgery because of the possibility of rapid deterioration of kyphoscoliosis and subsequent spinal cord disorders.
关于综合征性脊柱侧凸合并先天性椎体异常的报道较少。我们报告一例伴有先天性楔形椎体的索托斯综合征病例,其脊柱后凸侧弯在生长突增期进展迅速并出现脊髓病。一名12岁患有索托斯综合征并伴有T10楔形椎体的男性出现双下肢轻瘫和排尿功能障碍。磁共振成像显示脊髓向凹侧偏移,并在T10水平受到右侧椎弓根和椎体后壁的压迫。他接受了包括右侧T10椎弓根切除术及T5至L1节段矫正固定的直接减压手术。术后,他的步态障碍得到改善,且不再有尿失禁。他的脊柱后凸侧弯也有所改善。像本例中的索托斯综合征和先天性椎体异常这两种先天性疾病,需要仔细随访或早期手术干预,尤其是在生长突增期,以避免因脊柱后凸侧弯可能迅速恶化及随后出现脊髓疾病而错过手术的最佳时机。