Bell D F, Walker J L, O'Connor G, Tibshirani R
Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Spine (Phila Pa 1976). 1994 Feb 15;19(4):406-11. doi: 10.1097/00007632-199402001-00005.
Considerable controversy exists in the orthopedic and neurosurgical literature over the true incidence and nature of spinal deformity after multiple-level cervical laminectomy in children. Eighty-nine patients with a mean radiographic follow up of 5.1 years (range 2-9 years) were reviewed. Mean age at surgery was 5.7 years (range 1 month-18 years). Most common diagnoses were Arnold-Chiari malformation, syringomyelia, or both (81%). Significant deformity developed in 46 patients (53%), with 33 developing a mean kyphosis of 30 degrees (range 5-105 degrees) and 13 developing a mean hyperlordosis of 62 degrees (range 40-95 degrees). Peak age at surgery of 10.5 years correlated weakly (P = 0.08) with the development of kyphosis. The development of hyperlordosis was strongly correlated (P = 0.01) with a peak age at surgery of 4.2 years. There was no correlation between diagnosis, sex, location, or number of levels decompressed and the subsequent development of deformity.
儿童多节段颈椎椎板切除术后脊柱畸形的真实发病率和性质在骨科和神经外科文献中存在相当大的争议。回顾了89例患者，平均影像学随访时间为5.1年（范围2 - 9年）。手术时的平均年龄为5.7岁（范围1个月 - 18岁）。最常见的诊断是阿诺德 - 奇阿利畸形、脊髓空洞症或两者皆有（81%）。46例患者（53%）出现了明显畸形，其中33例出现平均30度的后凸畸形（范围5 - 105度），13例出现平均62度的前凸畸形（范围40 - 95度）。手术时的峰值年龄10.5岁与后凸畸形的发生呈弱相关（P = 0.08）。前凸畸形的发生与手术时的峰值年龄4.2岁呈强相关（P = 0.01）。诊断、性别、减压部位或减压节段数量与随后的畸形发展之间没有相关性。
