Noordeen M H, Taylor B A, Edgar M A
Middlesex Hospital, London, United Kingdom.
Spine (Phila Pa 1976). 1994 Jun 15;19(12):1406-9.
An 18-year-old patient with "idiopathic" adolescent scoliosis is presented. A thoracic syrinx was detected as an incidental finding during magnetic resonance imaging of the spine.
Syringomyelia may be a risk factor for neurologic injury during correction of scoliosis, and in these cases, spinal cord monitoring may be of particular value.
Spinal distraction and instrumentation carry a risk of neurologic damage in patients with scoliosis and associated syringomyelia. Syringomyelia is a cause of scoliosis, and although neurologic problems are the usual symptom, scoliosis may be the only sign at initial examination. A higher risk of neurologic injury has been reported in corrective surgical treatment of patients with syringomyelia. The mechanism of cord damage is unclear. Monitoring of spinal cord function is recommended to detect intraoperative neurological injury, which may be reversed on removing distraction and implants.
Intraoperative somatosensory-evoked potential (SSEP) spinal cord monitoring detected possible cord damage during outrigger distraction. Reduction of distraction led to a recovery of SSEPs and a satisfactory operative outcome.
Syringomyelia may be a risk factor for neurologic injury during correction of scoliosis, and SSEP spinal cord monitoring may identify and prevent intraoperative spinal cord injury.
报告一名18岁患有“特发性”青少年脊柱侧凸的患者。在脊柱磁共振成像检查时意外发现了一个胸段脊髓空洞症。
脊髓空洞症可能是脊柱侧凸矫正术中神经损伤的一个危险因素，在这些病例中，脊髓监测可能具有特殊价值。
脊柱撑开和器械植入对脊柱侧凸合并脊髓空洞症患者存在神经损伤风险。脊髓空洞症是脊柱侧凸的一个病因，虽然神经问题是常见症状，但脊柱侧凸可能是初次检查时的唯一体征。据报道，脊髓空洞症患者在矫正手术治疗中神经损伤风险更高。脊髓损伤的机制尚不清楚。建议进行脊髓功能监测以检测术中神经损伤，去除撑开力和植入物后损伤可能会逆转。
术中体感诱发电位（SSEP）脊髓监测在撑开器撑开时检测到可能的脊髓损伤。减少撑开力后SSEP恢复，手术结果满意。
脊髓空洞症可能是脊柱侧凸矫正术中神经损伤的一个危险因素，SSEP脊髓监测可识别并预防术中脊髓损伤。
