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MORPHOMETRIC STUDY OF THE C6 AND C7 PEDICLE: A COMPUTERIZED TOMOGRAPHY ANALYSIS c6和c7椎弓根的形态测量学研究:计算机断层扫描分析
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222104262589
Guilherm Otto Martin-Schutz, Carlos Alexandre Botelho do Amaral, P. Labronici, L. Pires
ABSTRACT Objective: Measure the diameter and thickness of the C6 and C7 pedicles using computed tomography, to analyze the security of the act surgery and the difference between males and females. Methods: This is a retrospective study. Two hundred computerized tomography scans of the cervical spine, one hundred male and one hundred female, from the Hospital Santa Teresa Radiology sector were evaluated. The pedicle thickness was measured in the axial plane, and the height was measured in sagittal slices. The student’s t-test was used to compare differences between the sexes, and a p-value lower than 0.05 was considered significant. Results: The mean age of the individuals included in the sample was 35±9 years. The mean height of the C6 and C7 pedicles were 7.1±0.9 mm and 7.8±0.9 mm, respectively. The mean thickness of the C6 and C7 pedicles were 5.2±0.7 mm and 5.9±0.8 mm, respectively. The statistical test showed that the values were significantly lower for female patients. Conclusions: The present study demonstrated parameters that can be used and can be the rule for preoperative planning of transpedicular cervical fixation surgeries, both in C6 and C7. As it is a procedure that can cause iatrogenic damage to important structures, the screw size must be chosen with care in pre-operative planning to avoid vessel rupture or damage to adjacent nerves. Level of Evidence III; retrospective study.
目的:利用计算机断层扫描测量C6、C7椎弓根的直径和厚度,分析该手术的安全性及男女差异。方法:回顾性研究。对圣特蕾莎医院放射科的200张颈椎计算机断层扫描图进行了评估,其中100张是男性,100张是女性。在轴向面测量椎弓根厚度,矢状面测量椎弓根高度。采用学生t检验比较性别差异,p值小于0.05被认为是显著的。结果:纳入样本的个体平均年龄为35±9岁。C6和C7椎弓根平均高度分别为7.1±0.9 mm和7.8±0.9 mm。C6和C7椎弓根平均厚度分别为5.2±0.7 mm和5.9±0.8 mm。统计检验表明,女性患者的数值明显较低。结论:本研究提供的参数可作为C6和C7颈椎经椎弓根固定手术术前规划的准则。由于该手术可引起重要结构的医源性损伤,因此在术前计划中必须谨慎选择螺钉的大小,以避免血管破裂或损伤邻近神经。证据等级III;回顾性研究。
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引用次数: 0
IS QUALITY OF LIFE WORSE IN PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS WHO UNDERGO LONGER FUSIONS? 2 YEARS OF FOLLOW-UP 青少年特发性脊柱侧凸患者的生活质量是否较长时间的融合更差?2年随访
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222102261930
Amauri Chaves Filho, Jeinnifer Zanardo Quaggiotto, Igor de Barcellos Zanon, José lucas Batista Júnior, I. M. Cardoso, Charbel Jacob Júnior
ABSTRACT Objective: To compare quality of life in patients with longer fusions with that of those who have short fusions 2 years of after surgery. Methods: This is a retrospective comparative cohort study (Level of Evidence III) involving patients with adolescent idiopathic scoliosis who underwent posterior spinal fusion with pedicle screws with a 2-year follow-up. The primary outcome was quality of life assessed using the SRS-30 questionnaire. Participants were divided according to Lenke and stratified into those with major (Lenke 3 and Lenke 6) and minor (Lenke 1 and Lenke 5) fusions. Results: Forty-one patients, 34 of whom were women, were evaluated: Lenke 1 (17 patients), Lenke 3 (15 patients), Lenke 5 (3 patients), and Lenke 6 (6 patients). The mean age was 13.8 years, the mean preoperative and postoperative Cobb angles were 56.48 degrees and 10.49 degrees, respectively, and the mean surgical Cobb reduction was 45.54 degrees. All patients in the sample showed an overall improvement in quality of life after surgery (p<0.0001). There was no difference between groups A (long fusions) and B (short fusions) in relation to the domains in general (p>0.05). Although pain was improved in the overall sample, this was not the case for the group with structured double curves and longer fusions (p = 0.03). Conclusion: There was no difference in quality of life between patients with long and short fusions with a 2-year follow-up. Level of Evidence III; Retrospective cohort.
目的:比较术后2年较长融合时间与较短融合时间患者的生活质量。方法:这是一项回顾性比较队列研究(证据水平为III),涉及青少年特发性脊柱侧凸患者,他们接受后路椎弓根螺钉融合术,随访2年。主要结果是使用SRS-30问卷评估生活质量。参与者根据Lenke进行分组,分为大融合组(Lenke 3和Lenke 6)和小融合组(Lenke 1和Lenke 5)。结果:共纳入41例患者,其中女性34例:Lenke 1(17例)、Lenke 3(15例)、Lenke 5(3例)、Lenke 6(6例)。平均年龄13.8岁,术前术后平均Cobb角分别为56.48度和10.49度,手术平均Cobb复位为45.54度。所有患者术后生活质量均有整体改善(p0.05)。虽然疼痛在整个样本中得到了改善,但对于结构双曲线和较长融合的组,情况并非如此(p = 0.03)。结论:经2年随访,长、短融合患者的生活质量无明显差异。证据等级III;回顾性队列。
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引用次数: 0
LOCKED-IN SYNDROME AFTER TRAUMATIC ATLANTOAXIAL SUBLUXATION: A CASE REPORT 外伤性寰枢椎半脱位后闭锁综合征1例
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222103261273
F. S. Santos, L. M. D. Costa
ABSTRACT Traumatic atlanto-axial subluxation is a rare and underdiagnosed condition due to its high rate – reported to be between 60 and 80% – of early mortality. Its diagnosis takes into account the trauma mechanism, precise analyses of the imaging tests and the clinical presentation of the patient. This article describes a rare presentation of atlanto-axial subluxation associated with craniocervical dislocation as a case of locked-in syndrome. Level of evidence V; Retrospective observational study – Case report.
外伤性寰枢半脱位是一种罕见且未被充分诊断的疾病,因为它的早期死亡率很高——据报道在60%到80%之间。其诊断考虑到创伤机制、影像学检查的精确分析和患者的临床表现。这篇文章描述了一个罕见的寰枢半脱位合并颅颈脱位的闭锁综合征病例。证据水平V;回顾性观察性研究-病例报告。
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引用次数: 0
EFFECT OF PHYSICAL TRAINING IN OBESE PATIENTS WITH LOW BACK PAIN: A SYSTEMATIC REVIEW 体育锻炼对肥胖腰痛患者的影响:一项系统综述
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222103263012
Roque Ribeiro DA SILVA JÚNIOR, Vinicius Iley Oliveira Rodrigues, Camila Fernandes Maia DE Carvalho, Perla Silva Rodrigues, Érica Galdino Félix, Lígia Fernanda DE Araújo, Adalberto Veronese da Costa, G. A. Cardoso
ABSTRACT Objective: To understand the hypoalgesic effect of exercises in obese patients with low back pain. Methods: From the methodological point of view, this is a systematic review study supported by the PRISMA guidelines (2020). Only clinical trials with defined eligibility criteria were included and the methodological evaluation was carried out using the Risk of Bias 2.0 (RoB 2.0) tool. Results: Four clinical trials were found, which underwent an assessment of risk of bias and were mostly categorized as moderate risk of bias or with some concerns. Conclusions: Moderate-intensity interval training (MIIT), high-intensity interval training (HIIT), and total resistance or lumbar spine extension exercises were shown to be effective for pain control, quality of life, and functional performance in obese individuals. On the other hand, the exercises alone did not produce a decrease in body composition. Level of evidence I; Systematic review.
摘要目的:了解运动对肥胖腰痛患者的镇痛作用。方法:从方法学的角度来看,这是一项由PRISMA指南(2020)支持的系统综述研究。仅纳入具有明确资格标准的临床试验,并使用风险偏倚2.0 (RoB 2.0)工具进行方法学评价。结果:共发现4项临床试验,对其进行了偏倚风险评估,大多被归类为中度偏倚风险或存在一定的担忧。结论:中等强度间歇训练(MIIT)、高强度间歇训练(HIIT)和完全阻力或腰椎伸展运动被证明对肥胖个体的疼痛控制、生活质量和功能表现有效。另一方面,运动本身并没有导致身体成分的减少。证据等级I;系统的回顾。
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引用次数: 0
PREVALENCE AND CHARACTERISTICS OF UPPER LUMBAR DISC HERNIATIONS IN OUR PRACTICE: A RETROSPECTIVE ANALYSIS 在我们的实践中,上腰椎间盘突出的患病率和特点:回顾性分析
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222101259474
Herman Michael Dittmar-Johnson, F. Cruz-López, Eduardo González-Camacho, Oscar Mikhail Chavarreti-Gutiérrez, Alejandro Tejera-Morett, F. Sánchez-García, Jorge De Haro-Estrada
ABSTRACT Introduction: Upper lumbar disc herniations (ULDH) are considered infrequent injuries (1-11%). They present, most often in older adults, with special clinical features that make diagnosis and therapeutic decision-making difficult. The prevalence, location, and management of these herniations and the medical history of our patients were analyzed. Methods: Sex, age, injury level, previous surgery, and patient treatment data from July 2018 to May 2021 were collected retrospectively. During this period, 179 patients underwent surgery, 33 of whom patients presented ULDH. Results: Thirty-three patients were included in the study (18 male and 15 female). Ages ranged from 39 to 85 years, with a predominance of elderly patients. The levels operated were L1-L2 in seven patients, L2-L3 in ten patients, L3-L4 in fourteen patients, and surgery in two levels (L2-L3, L3-L4) in two patients. In our practice, microdiscectomy is the preferred approach and was performed in all cases, with the addition of fusion in four of the 33 patients. Finally, a history of low lumbar disc herniation (LLDH) surgery was found in 16 patients. Conclusions: In our population, ULDHs are a rare entity with lower prevalence at the higher lumbar levels. They occur more frequently in elderly patients and clinical presentation can vary, which is a challenge for surgeons. In older adults, the development of lumbar kyphosis due to vertebral wedging is considered a risk factor for the development of ULDH. Surgical management by microdiscectomy is considered a technique with good results for this pathology. Level of Evidence III; Retrospective, longitudinal, descriptive, observational study.
摘要:上腰椎间盘突出症(ULDH)被认为是罕见的损伤(1-11%)。他们最常出现在老年人身上,具有特殊的临床特征,使诊断和治疗决策变得困难。我们分析了这些疝的患病率、位置和处理以及患者的病史。方法:回顾性收集2018年7月至2021年5月患者的性别、年龄、损伤程度、既往手术和治疗资料。在此期间,179例患者接受了手术,其中33例患者出现ULDH。结果:33例患者纳入研究,其中男性18例,女性15例。年龄39 ~ 85岁,以老年患者为主。7例手术水平为L1-L2, 10例为L2-L3, 14例为L3-L4, 2例手术水平为L2-L3, L3-L4。在我们的实践中,微椎间盘切除术是首选的方法,在所有病例中都进行了手术,在33例患者中有4例进行了融合。最后,16例患者有腰椎间盘突出症(LLDH)手术史。结论:在我们的人群中,ULDHs是一种罕见的实体,在较高的腰椎水平患病率较低。老年患者多见,临床表现各不相同,这对外科医生来说是一个挑战。在老年人中,由于椎体楔入导致的腰椎后凸被认为是ULDH发展的危险因素。显微椎间盘切除术被认为是一种治疗这种病理效果良好的技术。证据等级III;回顾性、纵向、描述性、观察性研究。
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引用次数: 1
LOW BACK AND NECK PAIN IN PHYSICAL EDUCATION STUDENTS: PREVALENCE AND ASSOCIATED FACTORS 体育学生腰颈疼痛:患病率及相关因素
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222101252315
L. Pivotto, Isis Menezes De Azevedo, Laisi Oliveira Rynkowski, C. Candotti
ABSTRACT Objective: To analyze the prevalence of low back and neck pain in Physical Education (PE) students at the Universidade Federal do Rio Grande do Sul (UFRGS) and the associated behavioral and postural factors. Methods: The study design is observational with descriptive analytics. Healthy PE students of both sexes participated in the study and answered the Back Pain and Body Postural Evaluation Instrument for Adults. Data were analyzed using SPSS software (21.0) using descriptive statistics, calculating the prevalence ratios and 95% confidence intervals. The significance level adopted was 0.05. Results: Ninety-two PE students answered the questionnaire, 45 of whom were females (48.9%) and 47 of whom were males (51.1%). The prevalence of low back pain was 76.1% and of neck pain was 58.7%. There was no association with most of the behavioral and postural factors assessed. Conclusions: The prevalence of low back and neck pain in PE students at UFRGS is high and this pain is not associated with the factors investigated. Level of Evidence II: Prospective study of less quality.
摘要目的:分析南大联邦大学(UFRGS)体育学生腰背部和颈部疼痛的患病率及其相关的行为和姿势因素。方法:采用描述性分析的观察性研究设计。健康的男女体育学生均参与了研究,并回答了成人背部疼痛和身体姿势评价量表。数据分析采用SPSS软件(21.0)进行描述性统计,计算患病率和95%置信区间。采用的显著性水平为0.05。结果:92名体育学生参与问卷调查,其中女生45人(48.9%),男生47人(51.1%)。腰痛的发生率为76.1%,颈痛的发生率为58.7%。与大多数被评估的行为和姿势因素没有关联。结论:UFRGS的体育学生腰背部和颈部疼痛的患病率很高,这种疼痛与所调查的因素无关。证据等级II:低质量的前瞻性研究。
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引用次数: 0
STUDY OF THE DIAMETER OF THE OBLIQUE CORRIDOR IN LATERAL DECUBITUS AND DORSAL DECUBITUS: RADIOLOGICAL STUDY 侧卧和背卧斜通道直径的影像学研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222103249402
M. Batista, R. Amaral, Fernando Antonio de Melo Filho, Gabriel Pokorny, M. Daher, R. Pratali, Daniel Arnoni, R. Moriguchi, L. Pimenta, C. F. Herrero
ABSTRACT Introduction: Degenerative intervertebral disc disease and its impact on quality of life when associated with sagittal misalignmentis a current topic in the literature. The technique known as OLIF derives from the need to use anterior cage stop romote stabilization of the affected segment, indirect decompression, restoration of segmental lordosis, and sagittal balance. Methods: Single-center, non-randomized, comparative, observational study. The following variables were measured using magnetic resonance imaging of the lumbar spine in dorsal and lateral decubitus, establishing a comparison between the size of the OLIF corridor in the L3L4 and L4L5 segments, as well as a comparison of corridor size between the different positions. Results: There was no difference incorridor size in the comparison between decubitus. However, when the L3L4 and L4L5 levels were compared, there was a significant difference in the size of the corridor in both the lateral and dorsal positions. Conclusion: The present study did not show any difference between the size of the OLIF corridor in L3L4 and L4L5 in the different decubitus, suggesting that thee valuation of the corridor in convention al magnetic resonance images appearstobe safe andreflects the actual size when positio ned for performing the OLIF technique. Level of evidence III; Retrospective study.
摘要:退行性椎间盘疾病及其对矢状位错位相关的生活质量的影响是目前文献中的一个话题。被称为OLIF的技术源于需要使用前弓形固定器来促进受影响节段的稳定,间接减压,恢复节段前凸和矢状面平衡。方法:单中心、非随机、比较、观察性研究。使用腰椎背卧位和侧卧位的磁共振成像测量以下变量,建立L3L4和L4L5节段OLIF通道大小的比较,以及不同位置之间通道大小的比较。结果:两组卧位患者的通道大小无明显差异。然而,当L3L4和L4L5水平比较时,无论是侧位还是背位,通道的大小都有显著差异。结论:本研究未发现不同卧位下L3L4和L4L5的OLIF通道的大小有任何差异,提示常规磁共振图像中通道的三种估值是安全的,并且在定位进行OLIF技术时反映了实际的大小。证据等级III;回顾性研究。
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引用次数: 0
THE EFFECT OF PILATES EXERCISES ON MUSCLE ELECTRICAL ACTIVATION IN ADULTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW 普拉提运动对慢性腰痛成人肌肉电激活的影响:一项系统综述
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222103262482
C. Romão, C. Mercê, Jéssica Filipa Costa Cordeiro, António Manuel Vitória Vences de Brito, Marco António Colaço Branco
ABSTRACT Low back pain is one of the most prevalent orthopedic conditions, affecting around 70% to 80% of the world’s population at least once during their life times. Surface electromyography is an important tool for assessing the muscle function of the lumbar stabilizers. One of the best treatment options for patients with chronic low back pain (CLBP) is physical exercise, particular lyaerobic exercise and Pilates, as these can reduce short-term pain and disability, and improve balance. This review aims to identify the state of art regarding the benefits of pilates on the population with CLBP, evaluating changes in the muscular activation of the muscles of the lumbar region. Searches were conducted on the following databases: PubMed (Medline), Science Direct, Scopus, Web of Science, Cochrane, Ebsco and Scielo; including gray literature: Google Scholar, Grey Literature, Pro Quest Dissertations & Theses. The inclusion criteria were adults with low back pain for three months or more, with or without referred pain in the lower limbs; studies that used electromyographic variables; studies with a pain assessment measure at two different times; studies with physical exercise performed only using the Pilates method. Applying these criteria, the searches retrieved 439 abstracts. Of these, 44 articles were evaluated for eligibility, and three fulfilled the qualitative and quantitative synthesis criteria. The average methodological quality score on the Downs and Black checklist was 15 out of 28. It was therefore concluded that Pilates is an excellent option for the treatment of non-specific low back pain, promoting health and helping prevent low back pain among asymptomatic individuals. Level of evidence II; Systematic Review of Level II or Level I Studies with Discrepant Results.
腰痛是最常见的骨科疾病之一,影响了世界上70%至80%的人口在其一生中至少一次。表面肌电图是评估腰椎稳定器肌肉功能的重要工具。慢性腰痛(CLBP)患者的最佳治疗选择之一是体育锻炼,特别是有氧运动和普拉提,因为这些可以减少短期疼痛和残疾,并改善平衡。本综述旨在确定普拉提对CLBP患者的益处,评估腰区肌肉激活的变化。检索数据库包括PubMed (Medline)、Science Direct、Scopus、Web of Science、Cochrane、Ebsco和Scielo;包括灰色文献:谷歌Scholar,灰色文献,Pro Quest dissertation & dissertation。纳入标准为腰痛持续3个月或以上的成年人,伴或不伴下肢牵涉性疼痛;使用肌电图变量的研究;在两个不同时间进行疼痛评估的研究;只使用普拉提方法进行体育锻炼的研究。应用这些标准,搜索得到了439篇摘要。其中44篇文章进行了合格性评价,3篇符合定性和定量综合标准。在Downs和Black检查表上的平均方法质量得分为15分(满分28分)。因此得出结论,普拉提是治疗非特异性腰痛的一个很好的选择,促进健康,并有助于预防无症状个体的腰痛。证据等级II;对结果不一致的二级或一级研究进行系统评价。
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引用次数: 1
CLINICAL AND RADIOLOGICAL OUTCOMES OF THE NEUROMUSCULAR SCOLIOSIS TREATMENT WITH S2-ALAR-ILIAC SCREW BY INTRAOPERATIVE NAVIGATION 术中导航骶髂椎弓根螺钉治疗神经肌肉性脊柱侧凸的临床及影像学观察
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222103264716
Alex Oliveira de Araújo, C. N. C. Segundo, R. Gepp, C. R. Gomes
ABSTRACT Objective: Analyze the clinical and radiological aspects of the S2AI screw technique in patients with neuromuscular scoliosis undergoing deformity correction surgery by intraoperative navigation. Methods: Retrospective analysis of medical records of patients undergoing neuromuscular scoliosis correction surgery with the S2-alar-iliac technique between 2017-2020. Results: In the total sample of 35 patients, 18 (51.4%) were female, with an average age of 14.9. The average preoperative coronal curve was 100° ± 26.2, with an average correction of 55% ± 16.3, with an average coronal curve of 44.8°± 19.5 at the end of surgery and 45 ° ± 19.6 at the end of follow-up. The average preoperative pelvic obliquity was 27.9°± 10.9, with a correction rate of 66.1% ± 27.6, being 8.2° ± 5.4 at the end of surgery and 9 .4°± 7.0 at the end of the follow-up. The average of operated levels was 17.3± 0.7. All 70 S2 screws had a diameter of 7mm. The average duration of surgeries was 416 ± 86 minutes, with estimated intraoperative bleeding of 921 ± 394.1 ml. The average density of screws in the sample was 1.3 ± 0.2 screws per level, and the average density in the lumbosacral spine was 1.5 ± 0.2. Conclusions: Intraoperative navigation can contribute to the rate of complications related to the S2AI screw decrease; in addition, the length of this screw appears to have significant relevance in maintaining the correction throughout the follow-up. Level of evidence IV; Case series.
【摘要】目的:分析S2AI螺钉技术在行术中导航矫形术的神经肌肉型脊柱侧凸患者中的临床及影像学表现。方法:回顾性分析2017-2020年采用骶髂侧翼技术行神经肌肉型脊柱侧凸矫正手术患者的病历。结果:35例患者中,女性18例(51.4%),平均年龄14.9岁。术前冠状曲线平均为100°±26.2,平均矫正率为55%±16.3,手术结束时冠状曲线平均为44.8°±19.5,随访结束时冠状曲线平均为45°±19.6。术前平均骨盆倾斜度为27.9°±10.9,矫正率为66.1%±27.6,手术结束时为8.2°±5.4,随访结束时为9.4°±7.0。手术水平平均值为17.3±0.7。70颗S2螺钉直径均为7mm。平均手术时间416±86分钟,估计术中出血921±394.1 ml。样本中平均螺钉密度为每节1.3±0.2颗,腰骶棘平均密度为1.5±0.2颗。结论:术中导航可降低S2AI螺钉相关并发症的发生率;此外,在整个随访过程中,螺钉的长度似乎与维持矫正有重要关系。证据等级IV;病例系列。
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引用次数: 0
SPINAL DERMAL SINUS COMPLICATION IN CHILDREN: CASE SERIES AND LITERATURE REVIEW 儿童脊髓真皮窦并发症:病例系列及文献回顾
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/s1808-185120222104259898
D. Forlino, P. Manzone, D. Ebel, Romilio Monzón, Hugo Marcelo Wirz
ABSTRACT Introduction: Dermal sinus (DS) is a rare dysraphism. It can be asymptomatic, become infected, and produce severe neurological symptoms. Our objective is to present a series of pediatric cases with spinal DS complicated byinfections (DSCI), describe the findings correlated with the anatomy in a stillbirth, as well as the associated pathologies and their treatment. Method: We analyzeddifferent variables in the clinical histories of 5 children with spinal DSCI. In addition, an anatomical dissection of a stillbirth with lumbar DS was performed. Results: Two males and 3 femaleswith DSCI and a mean age of 2 years and 9 months were included: 2 lumbar (one in the midline and the other in theparamedian region), 1 in the thoracic region, 1 in the upper cervical region,and 1 in the lumbosacral region. The forms of presentation were 3 meningeal profiles (one with pain andlocalized swelling) and 3 neurological deficits (one associated with the meningeal profile and another associated with pain and a tumor). In all cases, the tract of the DS was identified by magnetic resonance imaging (MRI).Associated lesions included 1 dorsal intramedullary dermoid cyst, 1 tethered lumbar spinal cord with syringomyelia, 1 partial cervical medullary disconnection, and 2 spinal dysraphisms. Four were operated on and one died of infectious complications before surgery. In the 12-week-old male fetus with lumbar DS, a permeable tract to the subarachnoid space was verified. Conclusions: DSCIsshould bestudied with MRI to identify their tracts, infectious complications of thecentral nervous system, associated malformations, inclusion tumors, and to enabledifferential diagnosis. Once diagnosed, they should be urgently treated both surgically and with prolonged antibiotictherapy. Level of Evidence IV; Therapeutic Study (Treatment Outcome Investigation)
摘要简介:真皮窦(DS)是一种罕见的畸形。它可以是无症状的,被感染,并产生严重的神经系统症状。我们的目的是报道一系列小儿脊髓退行性椎体滑移合并感染(DSCI)的病例,描述死产的解剖结果,以及相关病理和治疗方法。方法:对5例脊髓性脊髓损伤患儿的临床病史进行分析。此外,解剖解剖死胎腰椎退行性椎体滑移进行了。结果:包括2名男性和3名女性,平均年龄2岁零9个月:2名腰椎(1名在中线,另一名在正中区),1名在胸区,1名在上颈区,1名在腰骶区。表现形式为3种脑膜特征(一种伴有疼痛和局部肿胀)和3种神经功能缺损(一种与脑膜特征有关,另一种与疼痛和肿瘤有关)。在所有病例中,通过磁共振成像(MRI)确定了DS的束。相关病变包括1例脊背髓内皮样囊肿,1例脊髓栓系伴脊髓空洞,1例部分颈髓断裂,2例脊柱发育异常。其中4人接受手术,1人在手术前死于感染并发症。在12周大的男性腰椎退行性椎体滑移胎儿中,证实了蛛网膜下腔的可渗透通道。结论:应结合MRI对dsciso进行研究,以确定其束,中枢神经系统的感染性并发症,相关畸形,包涵性肿瘤,并进行鉴别诊断。一旦确诊,应立即进行手术和长期抗生素治疗。证据水平IV;治疗研究(治疗结果调查)
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引用次数: 0
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