Fromm B, Carstens C, Graf J
Abteilung für Orthopädie im Kindesalter, Orthopädische Universitätsklinik Heidelberg.
Z Orthop Ihre Grenzgeb. 1994 Jan-Feb;132(1):56-61. doi: 10.1055/s-2008-1039820.
The findings in abdominal aortography performed preoperatively in 21 children with myelomeningocele (MMC), which underwent kyphectomy due to congenital kyphosis of the lumbar spine, are reported. In no case did the aorta follow the kyphotic radius of curvature. It rather seemed to be strung over the kyphosis like a tendon over a bow. An intraoperative lesion of the aorta seems rather unlikely, and this is why we believe, that a routinely performed preoperative abdominal aortography is not necessary. We found a remarkable number of anomalies of the intercostal and segmental arteries, which were only in part associated with deformities of the vertebral bodies. The kidneys seemed to be imbedded in the kyphotic concavity, partially with the inferior pole, partially in whole. In these cases the risk of intraoperative lesion seems higher. We found a number of cases with unilateral agenesis of the kidneys in the patients examined by us. Therefore we suggest the use of noninvasive methods prior to surgery in order to evaluate the presence of malpositions or malformations of the kidneys.
报告了21例因腰椎先天性后凸而行后凸切除术的脊髓脊膜膨出（MMC）患儿术前腹部主动脉造影的结果。在所有病例中，主动脉均未遵循后凸的曲率半径。它更像是像弓弦上的肌腱一样横跨在后凸上。术中主动脉损伤似乎不太可能，这就是为什么我们认为常规进行术前腹部主动脉造影没有必要。我们发现了大量肋间动脉和节段性动脉异常，这些异常仅部分与椎体畸形有关。肾脏似乎嵌入后凸凹面，部分下极嵌入，部分整个嵌入。在这些情况下，术中损伤的风险似乎更高。我们在我们检查的患者中发现了一些单侧肾缺如的病例。因此，我们建议在手术前使用非侵入性方法来评估肾脏是否存在位置异常或畸形。
