文章简介

出版社:Journal of neurosurgery. Spine

作   者:Shaheryar F. ansari, richard B. rodgers and Daniel H. Fulkerson

编   号:10.3171/2014.9.SPINE1411

年   份:2015    点击量:700

文章摘要 全文翻译

        Congenital scoliosis from laterally located hemivertebrae at the lumbosacral junction has been described previously. However, dorsally located midline hemivertebrae at this location have not been reported. The authors describe the presentation, treatment, and outcomes of 2 patients (1 male and 1 female) with this rare malformation. All clinical and radiographic records were reviewed. Outcomes were recorded using survey instruments (Oswestry Disability Index and the 36-Item Short Form Health Survey). Radiographic assessment of bony fusion was performed using CT scanning 1 year after surgery. Both patients presented with back and leg pain, urinary hesitancy/incontinence, difficulty sitting and lying down, waddling gait, and restriction of movement. Imaging showed a wedge-shaped dorsal deformity that stretched the nerve roots and compressed the canal. Both patients underwent resection of the hemivertebra with posterolateral instrumented fusion from L-2 to the pelvis. The female patient had a low-lying conus and underwent sectioning of the filum terminale. Both patients showed improvement in the ability to sit and lie flat and in bowel and bladder function after surgery. The authors describe their experience with 2 patients with similar, rare congenital bony deformities at the lumbosacral junction. To their knowledge, similar cases have not been previously reported.

        腰骶连接处位于半椎体的先天性脊柱侧弯曾有报道。然而,在此处的背侧中线半椎体尚无报道。作者们描述2例这种罕见畸形患者(男性和女性各1例)的临床表现、治疗和结果。回顾所有临床和影像学档案。运动评估量表对病情进行评估和记录(Oswestry功能障碍指数和36项简易健康调查)。术后1年利用CT扫描完成骨融合的影像学评估。两位患者均表现出腰腿痛、排尿踌躇/尿失禁、坐及躺困难、摇摆步态和活动受限。图像显示一个楔形的背侧畸形,该畸形拉伸神经根和压迫神经管。两位患者均接受了从L-2到骨盆后外侧器械融合的半椎体切除术。女性患者存在低位圆锥并接受了终丝切断术。术后两位患者坐下和平躺的能力及大小便功能均有改善。作者们介绍了与这两例患者相似,罕见的腰骶连接处的先天性骨畸形的经验。据他们所知,以前尚无相似病例的报道。