Zadeh H G, Sakka S A, Powell M P, Mehta M H
Scoliosis Unit, Royal National Orthopaedic Hospital Trust, Stanmore, UK.
J Bone Joint Surg Br. 1995 Sep;77(5):762-7.
We describe 12 children with idiopathic scoliosis who had a persistent absent superficial abdominal reflex (SAR) on routine neurological examination. MRI showed syringomyelia to be present in ten. The average age at detection of the scoliosis was 4.3 years and at diagnosis of syringomyelia 6.6 years. In all ten children the SAR was consistently absent on the same side as the convexity of the curve. In two it was the only abnormal neurological sign. An absent SAR in patients with scoliosis is an indication for investigation for underlying syringomyelia. In the children with syringomyelia, six had thoracic and four thoracolumbar curves. The clinical features differed in the two groups. Patients with thoracic curves were generally asymptomatic. Their neurological signs were subtle and none had any motor signs. By contrast, patients with thoracolumbar curves had symptoms and neurological signs. Abnormal gait was present in all four patients with thoracolumbar curves. In three this was due to considerable motor weakness. In eight children syringomyelia was associated with a Chiari-I malformation. In seven the syrinx was treated surgically by decompression of the foramen magnum.
我们描述了12例患有特发性脊柱侧凸的儿童，他们在常规神经学检查中持续存在腹壁浅反射（SAR）缺失。磁共振成像（MRI）显示其中10例存在脊髓空洞症。脊柱侧凸被发现时的平均年龄为4.3岁，脊髓空洞症被诊断时的平均年龄为6.6岁。在所有10例儿童中，SAR在脊柱侧凸凸侧同侧始终缺失。在2例中，这是唯一的异常神经学体征。脊柱侧凸患者中SAR缺失提示需对潜在的脊髓空洞症进行检查。在患有脊髓空洞症的儿童中，6例为胸段脊柱侧凸，4例为胸腰段脊柱侧凸。两组的临床特征有所不同。胸段脊柱侧凸的患者通常无症状。他们的神经学体征不明显，且均无任何运动体征。相比之下，胸腰段脊柱侧凸的患者有症状和神经学体征。所有4例胸腰段脊柱侧凸的患者均存在异常步态。其中3例是由于明显的运动无力。在8例儿童中，脊髓空洞症与Chiari-I畸形相关。在7例中，通过枕骨大孔减压对脊髓空洞进行了手术治疗。
