腰骶部融合术治疗高位脊柱侧凸后,儿童畸形脊柱侧凸自发改善:四例新病例报告及文献系统回顾。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-07-05 eCollection Date: 2023-08-01 DOI:10.1177/18632521231182427
Charles T Mehlman, Alvin H Crawford
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引用次数: 0

摘要

背景:本研究的目的是介绍四例有据可查的自发性脊柱侧凸改善病例,并分析文献中的有据可查病例:该研究旨在介绍四例有据可查的新的自发性脊柱侧凸改善病例,并对文献中的有据可查的病例进行分析:方法:进行外科日志检索和系统回顾。纳入标准为:(1) 年龄小于18岁;(2) 有症状的高位(≥50%)脊柱侧凸;(3) 脊柱侧凸≥20o;(4) 通过腰骶部融合术进行初次手术治疗;(5) 完整的X线片;(6) 至少1年的影像学随访或直至曲线消退:研究共纳入 13 名患者,平均年龄为 13.9 岁,其中 4 人来自作者的手术日志,9 人来自文献。L5-S1的滑动比例从51%到95%不等。胸廓曲线幅度平均为34.6°(范围:20°-45°),大多数患者(8/13)的胸廓曲线较长,躯干侧移。除一名患者外,其余患者均为先端右侧,躯干右移。其余曲线均为孤立的腰椎曲线,形态为顶点偏左,躯干无偏移。13 名患者中有 11 名在进行孤立的腰骶部融合术后曲线有所改善。三名患者的脊柱侧弯幅度减少了 12°-28°,八名患者的脊柱侧弯完全消除(≤10°):本研究总结了13例有充分证据证明的伴有症状的高位脊柱侧凸病例(4例为新病例,9例来自文献)。所有病例均采用腰骶部后路融合术进行治疗。腰骶部手术后,13 例脊柱侧弯患者中有 11 例的脊柱侧弯症状得到自发改善(8 例脊柱侧弯完全消失):证据级别:治疗级别 IV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Spontaneous improvement of olisthetic scoliosis in children following lumbosacral fusion for high-grade spondylolisthesis: A report of four new cases and systematic review of the literature.

Background: The study aim was to present four new well-documented cases of spontaneous improvement of olisthetic scoliosis and to analyze well-documented cases from the literature.

Methods: Surgical log search and systematic review were conducted. Inclusion criteria were (1) age less than 18 years, (2) symptomatic high-grade (≥50%) spondylolisthesis, (3) scoliosis ≥20o, (4) primary surgical treatment via lumbosacral fusion, (5) complete x-rays, and (6) minimum 1-year radiographic follow-up or until curve resolution.

Results: A total of 13 patients with average age of 13.9 years were included in the study, 4 from the authors' surgical logs and 9 from the literature. Slip percentage of L5-S1 ranged from 51% to 95%. Olisthetic curve magnitude averaged 34.6° (range: 20°-45°) with majority (8/13) demonstrating long thoracic curves with lateral trunk shift. All but one of these were apex right with rightward trunk shift. The remainder of the curves were isolated lumbar curves, with an apex left morphology without trunk shift. Eleven of the 13 patients showed curve improvement following isolated lumbosacral fusion. Three patients experienced a decrease in curve magnitude of 12°-28° and eight patients enjoyed complete resolution (≤10°) of their scoliosis.

Conclusion: The current study summarizes 13 well-documented cases of olisthetic scoliosis (4 new cases and 9 from the literature) that associated with symptomatic high-grade spondylolisthesis. All were treated via a primary posterior lumbosacral fusion strategy. Eleven of the 13 curves showed spontaneous improvement (8 complete resolution of scoliosis) following their lumbosacral surgery.

Level of evidence: Therapeutic level IV.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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