Emery E, Redondo A, Rey A
Department of Neurosurgery, Beaujon Hospital, Clichy, France.
Eur Spine J. 1997;6(3):158-62. doi: 10.1007/BF01301429.
The authors analysed the clinical and radiological findings and the surgical management of 25 patients admitted for scoliosis classified as idiopathic at first presentation, but in fact associated with spinal cord and/or brain stem anomalies. Twenty patients had syringomyelia, 19 had Chiari malformation. Scoliosis was the only presenting symptom when all these patients were referred to the orthopaedic surgeon. On examination, five patients had normal neurological findings, while the others showed very mild neurological deficits. The diagnosis of syringomyelia and Chiari malformation was established by MRI, which is the best form of neuroradiological examination for discovering spinal abnormalities. Neurosurgical treatment is strongly recommended as the first step in the management of "pseudo" idiopathic scoliosis.
作者分析了25例最初表现为特发性脊柱侧弯但实际上与脊髓和/或脑干异常相关的患者的临床、影像学检查结果及手术治疗情况。20例患者患有脊髓空洞症，19例患有Chiari畸形。当所有这些患者被转诊至骨科医生处时，脊柱侧弯是唯一的就诊症状。经检查，5例患者神经学检查结果正常，而其他患者表现出非常轻微的神经功能缺损。脊髓空洞症和Chiari畸形的诊断通过MRI得以确立，MRI是发现脊柱异常的最佳神经放射学检查方式。强烈建议将神经外科治疗作为“假性”特发性脊柱侧弯治疗的第一步。
