儿童脊柱退行性病变,伴有根综合征:17岁区域队列的流行病学和临床分析

Q3 Medicine Hirurgia Pozvonochnika Pub Date : 2019-03-30 DOI:10.14531/SS2019.1.38-47
Виктор Павлович Снищук, А. Ю. Мушкин
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引用次数: 1

摘要

目标。以俄罗斯联邦最大的一个地区为例,分析儿童脊柱退行性疾病合并神经根综合征的流行病学和临床特征及其治疗效果。材料和方法。该研究的设计符合一项回顾性队列临床和流行病学研究,为期17年。该研究包括201例年龄在10-17岁的脊柱退行性改变合并神经根综合征的患者。流行病学分析包括评估儿童脊柱退行性疾病的区域发病率,以及临床分析-保守治疗和手术治疗的有效性。分析了队列的年龄和性别结构,病理水平,手术治疗的有效性,以及与成人脊柱退行性病变相比,儿童早期椎间盘的年龄相关特征。结果。据评估,列宁格勒地区伴有临床表现并需要特殊治疗的退行性疾病的流行病学频率为每10万名10-17岁儿童8.7人。保守治疗172例有效,手术治疗29例。术后随访1 ~ 16年,评价为优秀4例(14%),良好20例(69%),满意5例(17%)。报告了两例并发症:椎间稳定植入物移位和腓神经与手术台上位置相关的位置神经病。结论。在列宁格勒地区的区域队列中进行的流行病学分析可用于评估俄罗斯其他地区对退行性病理患儿进行保守和手术治疗的潜在需求。保守治疗是相当有效的,只有14.4%的病例需要手术减压神经根。
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ДЕГЕНЕРАТИВНЫЕ ПОРАЖЕНИЯ ПОЗВОНОЧНИКА У ДЕТЕЙ, ОСЛОЖНЕННЫЕ КОРЕШКОВЫМ СИНДРОМОМ: ЭПИДЕМИОЛОГИЧЕСКИЙ И КЛИНИЧЕСКИЙ АНАЛИЗЫ 17-ЛЕТНЕЙ РЕГИОНАЛЬНОЙ КОГОРТЫ
Objective. To analyze epidemiological and clinical features of degenerative disease of the spine complicated by radicular syndrome in children, as well as the effectiveness of its treatment on the example of one of the largest regions of the Russian Federation. Material and Methods. Design of the study corresponds to a retrospective cohort clinical and epidemiological study for 17 years. The study included 201 patients aged 10–17 years with degenerative changes in the spine complicated by radicular syndrome. An epidemiological analysis included the assessment of the regional incidence of degenerative diseases of the spine in children, and clinical analysis – the effectiveness of conservative and surgical treatment. The age and sex structure of the cohort, the level of pathology, the effectiveness of surgical treatment, and age-related features of early spinal discosis in children as compared with degenerative lesions of the spine in adults were analyzed. Results. The epidemiological frequency of degenerative diseases accompanied by clinical manifestations and requiring special treatment in the Leningrad Region was assessed as 8.7 per 100 thousand children aged 10–17 years. Conservative treatment was effective in 172 patients, and 29 patients were treated with surgery. Surgical results were followed up for 1 to 16 years after surgery and were evaluated as excellent, good, and satisfactory respectively in 4 (14 %), 20 (69 %), and 5 (17 %) cases. Complications were reported in two cases: migration of the interbody stabilizing implant and positional neuropathy of the peroneal nerve associated with the position on the operating table. Conclusion . The epidemiological analysis conducted on a regional cohort of the Leningrad Region can be used in assessing the potential need for conservative and surgical treatment of children with degenerative pathology in other regions of Russia. Conservative treatment of this pathology is quite effective, and surgical decompression of nerve roots was required only in 14.4 % of cases.
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来源期刊
Hirurgia Pozvonochnika
Hirurgia Pozvonochnika Medicine-Anesthesiology and Pain Medicine
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
7 weeks
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