M Chehrassan, M Shakeri, F Nikouei, B Jafari, E A Mahabadi, H Ghandhari
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引用次数: 0
摘要
背景:成骨不全症(OI)是一种以骨骼畸形、骨脆性和脊柱并发症为特征的结缔组织疾病。各种研究强调了脊柱侧弯对肺功能的影响、脊柱融合术的积极成果以及术后功能的改善。然而,部分矫正功能的丧失仍然不可避免:本研究对六名接受过脊柱侧弯手术治疗的 OI 患者进行了调查。采用椎弓根螺钉和挂钩的后路手术干预,旨在矫正脊柱畸形。对术前、术后和随访进行了放射学评估,结果显示手术后脊柱侧弯角度明显缩小:并发症包括感染和近端交界性脊柱后凸,需要进行翻修手术。尽管骨质较差和植入物稳定性较差带来了挑战,但该系列手术中没有发生植入物失败的情况。畸形顶点的Ponte截骨术有助于矫正手术:结论:OI 患者脊柱侧凸的手术治疗具有挑战性,可能会出现围手术期和术后并发症。Ponte截骨术可改善矫正效果,减少矫正时所需的力量。
Surgical treatment of scoliosis in patients with osteogenesis imperfecta: a single institution case series.
Background: Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by skeletal deformities, bone fragility, and spinal complications. Various studies' insights underscored the impact of scoliosis on pulmonary function, positive outcomes with spinal fusion, and improved functional abilities post-surgery. However, partial loss of correction remains inevitable.
Methods: This study examines six surgically treated OI patients with scoliosis. Surgical intervention using a posterior approach with pedicle screws and hooks aimed to correct spinal deformities. Preoperative, postoperative, and follow-up radiological assessments were conducted, revealing significant reductions in scoliotic angles post-surgery.
Results: Complications included infections and proximal junctional kyphosis requiring revision surgeries. Despite the challenges posed by poor bone quality and implant stability, no implant failures occurred in this series. Ponte osteotomies at the apex of deformity aided in corrective maneuvers.
Conclusion: Surgical treatment of scoliosis in patients affected by OI is challenging and may be associated with perioperative and postoperative complications. Ponte osteotomy may improve the correction and reduce necessary force at the time of correction.
期刊介绍:
Musculoskeletal Surgery – Formerly La Chirurgia degli Organi di Movimento, founded in 1917 at the Istituto Ortopedico Rizzoli, is a peer-reviewed journal published three times a year. The journal provides up-to-date information to clinicians and scientists through the publication of original papers, reviews, case reports, and brief communications dealing with the pathogenesis and treatment of orthopaedic conditions.An electronic version is also available at http://www.springerlink.com.The journal is open for publication of supplements and for publishing abstracts of scientific meetings; conditions can be obtained from the Editors-in-Chief or the Publisher.