Bösch P, Reisner T
Z Orthop Ihre Grenzgeb. 1976 Oct;114(5):861-6.
More than 70 transverse lesion of the cord syndromes in chondrodystrophic dwarfs have been described in the literature. 43 of these were adequately described and/or accessible for the authors. In 22 cases, a mechanical cause (including 14 lesions of the intervertebral disk) was directly responsible and, in 14 cases, no direct spinal cord suppression was found. In the latter group, 10 had a negative myelography, 3 positive and 1 case myelography was not performed. Of the 12 laminectomized cases, only 3 made a good recovery, 4 showed severe deterioration and 2 conservatively treated cases (including the case described here) were clearly improved. Of the 16 laminectomized cases with limited mechanical impediment, 8 showed good results, 3 indifferent and 5 unknown. The cause of the vascular myleopathy was assumed to be a combination of the narrowness of the bony vertebral canal and an increasing kyphotic process. The authors suggest that laminectomy for tranverse lesion of the cord syndrome in dwarfs should be made only after several controls and an established stop correlating with the location of the neurological lesions. We reject decompression laminectomy for vascular myleopathy because of the already endangered vascular situation and the poor results. We prefer orthopedic measures.
文献中已描述了70多例软骨发育不全性侏儒脊髓横断性损伤综合征。其中43例有充分描述且作者可获取相关信息。22例中，机械性原因（包括14例椎间盘损伤）直接导致损伤，14例未发现直接的脊髓受压情况。后一组中，10例脊髓造影结果为阴性，3例为阳性，1例未进行脊髓造影。12例行椎板切除术的病例中，仅3例恢复良好，4例病情严重恶化，2例保守治疗的病例（包括此处描述的病例）明显好转。16例因机械性阻碍有限而行椎板切除术的病例中，8例效果良好，3例效果一般，5例情况不明。血管性脊髓病的病因被认为是骨性椎管狭窄和后凸畸形加重共同作用的结果。作者建议，对于侏儒脊髓横断性损伤综合征，仅在经过多次检查且确定与神经损伤部位相关的停止标准后，才可进行椎板切除术。由于血管状况已处于危险之中且效果不佳，我们不主张对血管性脊髓病行减压性椎板切除术。我们更倾向于采取矫形措施。
