文章简介

出版社:European Spine Journal

作   者:Eyal Behrbalk , Ofir Uri , Jonathan A. Clamp , Marcus Rickert , Bronek Maximilian Boszczyk

编   号:10.1007/s00586-014-3619-x

年   份:2015    点击量:771

文章摘要 全文翻译

Background

Correcting the chest wall deformity is an important goal of scoliosis surgery. A prominent rib hump deformity may not be adequately addressed by scoliosis correction alone. It has been shown that costoplasty in conjugation with scoliosis correction and instrumented spinal fusion is superior to spinal fusion alone in addressing the chest wall deformity. In cases of severe rib hump deformity unilateral convex side costoplasty alone might not adequately restore thoracic cage symmetry necessitating for additional concave side rib cage reconstruction.

背景

矫正胸壁畸形是脊柱侧凸手术的一个重要目的。单独脊柱侧凸矫正可能不能完全解决显著的肋骨隆起畸形。已有证据表明在解决胸壁畸形上,胸廓成形术配合脊柱侧凸矫形术和脊柱融合术优于单独脊柱融合术。如果发生严重的肋骨隆起畸形,单独凸侧肋骨成形术可能不能充分修复胸廓对称性,需要额外增加凹侧胸腔重建。

 

Case report

A 16-year-old male with adolescent idiopathic scoliosis and a sharp, cosmetically unacceptable, prominent rib hump (razorback deformity) underwent scoliosis correction with posterior spinal fusion and bilateral costoplasty. The convex-sided ribs were resected and used for concave-sided rib reconstruction. The rib hump height was reduced from 70 mm before the procedure to 10 mm after the procedure and the apical trunk rotation was reduced from 36° to 5°, respectively. Solid spinal fusion and ribs union was achieved. The patient remained very satisfied with no loss of correction at 2-year postoperative follow-up.

病例报告

1例16岁男性患者患有青少年特发性脊柱侧凸,并伴有尖锐的、外观无法接受的、显著的肋骨隆起(剃刀背畸形),该患者接受了脊柱侧凸矫形术及后路脊柱融合和双侧胸廓成形术的。凸侧肋骨被切除并被用于凹侧肋骨重建。肋骨隆起高度由术前70mm减少至术后10mm,脊柱侧弯角由36°减少至5°。完成牢固的脊柱融合和肋骨骨折愈合。该患者在术后2年随访时对未消失的矫正感到十分满意。

 

Conclusion

Bilateral costoplasty in conjugation with scoliosis correction may provide a safe and effective method for the treatment of severe rib cage deformities associated with thoracic scoliosis. It should be considered in the presence of prominent rib hump deformity, where scoliosis correction alone or with unilateral costoplasty is unlikely to provide adequate correction.

结论

双侧胸廓成形术配合脊柱侧凸矫形术可以为与胸椎侧凸相关的严重胸腔畸形的治疗提供一个安全有效的方法。在显著的肋骨隆起畸形,单独脊柱侧凸矫形术或单侧胸廓成形术不可能为其提供充分的矫正时,应考虑以上术式。