Evolution of syrinx in patients undergoing posterior correction for scoliosis associated with syringomyelia
Evolution of syrinx in patients undergoing posterior correction for scoliosis associated with syringomyelia
复制标题
因脊髓空洞症相关脊柱侧凸接受后路矫正的患者中空洞的演变
DOI：
10.1007/s00586-014-3694-z
复制
发表时间：
2015-05
影响因子：
2.8
通讯作者：
Zhu Zezhang
中科院分区：
文献类型：
--
作者：
Sha Shifu;Zhang Wen;Qiu Yong;Liu Zhen;Zhu Feng;Zhu Zezhang
目的虽然脊髓空洞相关脊柱侧凸的矫正手术经常导致脊柱伸长，并可能影响脊髓空洞的自然史，但有关术后空洞行为的数据却很少。本研究旨在调查接受一期后路器械脊柱融合术治疗特发性脊髓空洞症 (IS) 相关脊柱侧凸的患者中空洞的自然演变。方法对 22 名接受一期后路矫正和融合治疗的 IS 相关脊柱侧凸患者进行至少 12 个月的临床和 MRI 随访（平均 29.6 个月；范围 12-57 个月）进行评估。所有注射器均位于颈部或颈胸区域内。检查站立前后位X光片的主要曲线大小和术后矫正。在术前和后续 T2 加权 MR 图像中，对空洞腔的位置、结构和大小进行了系统评估，显着的空洞分辨率定义为长度或最大空洞/脊髓比减少超过 20%。结果术后主曲线矫正百分比平均为 64.0 ± 15.7%，并且在最新评估时保持良好 (58.5 ± 11.5%)。关于空洞大小，尽管配对测试显示术前和术后最大空洞/绳索比率之间没有统计学显着差异（0.44 与 0.41；P> 0.05），但 22 名患者中有 10 名 (45.5%) 被发现符合显着空洞分辨率的标准。此外，11 例 (50.0%) 患者的空洞稳定，而在最终随访时仅 1 例 (4.5%) 观察到空洞恶化。使用Spearman相关性检验，发现最大鸣管/脊髓比的改善率与主曲线的冠状百分比校正密切相关（r= -0.547，P= 0.008）。没有出现与手术相关的神经系统或其他主要并发症。 结论 对于在神经功能缺损极小的情况下治疗与 IS 相关的脊柱侧弯，一阶段脊柱融合加脊柱延长可提供有效的冠状面和矢状面矫正，且无神经系统并发症。手术后，绝大多数（95.5%）注射器收缩或保持稳定，表明畸形矫正不会对脊髓空洞症的自然进化产生有害影响。
PurposeWhile correction surgery for syringomyelia-associated scoliosis frequently results in an elongation of the spine and may potentially influence the natural history of syringomyelia, a paucity of data exists regarding the syrinx behavior in the postoperative course. This study aimed to investigate the natural evolution of syrinx in patients undergoing one-stage posterior instrumented spinal fusion for treatment of scoliosis associated with idiopathic syringomyelia (IS).MethodsTwenty-two patients with IS-associated scoliosis treated with one-stage posterior correction and fusion were evaluated at a minimum of 12-month clinical and MRI follow-up (mean 29.6 months; range 12–57 months). All syringes were located within the cervical or cervicothoracic region. Standing anteroposterior radiographs were examined for primary curve magnitude and postoperative correction. On preoperative and follow-up T2-weighted MR images, location, configuration and size of the syrinx cavity were systematically assessed, and significant syrinx resolution was defined as any more than 20 % decrease in length or maximal syrinx/cord ratio.ResultsPostoperative percent correction of the primary curve averaged 64.0 ± 15.7 % and was well maintained (58.5 ± 11.5 %) at latest evaluation. Regarding syrinx size, although pairedttest revealed no statistically significant difference between pre- and postoperative maximal syrinx/cord ratios (0.44 versus 0.41;P> 0.05), 10 of 22 (45.5 %) patients were found to meet the criteria for significant syrinx resolution. Additionally, 11 (50.0 %) patients had syrinx stabilization, whereas syrinx deterioration was observed only in 1 case (4.5 %) at final follow-up. Using Spearman correlation test, improvement rate of the maximal syrinx/cord ratio was found to be strongly related to the coronal percent correction of the primary curve (r= −0.547,P= 0.008). There were no neurologic or other major complications related to the surgery.ConclusionsFor treatment of scoliosis associated with IS in the setting of minimal neurological deficits, one-stage spinal fusion with a lengthening of the vertebral column provides an effective coronal and sagittal correction without neurologic complications. Following surgery, the vast majority (95.5 %) of syringes shrank or remained stable, indicating that deformity correction did not exert a deleterious effect on the natural evolution of syringomyelia.
登录
查看更多内容
影响因子：
2.8
作者：
Wang, Yingsong;Xie, Jingming;Si, Yongyu
通讯作者：
Si, Yongyu
影响因子：
4.1
作者：
OLDFIELD, EH;MURASZKO, K;PATRONAS, NJ
通讯作者：
PATRONAS, NJ
影响因子：
4.1
作者：
Heiss, JD;Patronas, N;Oldfield, EH
通讯作者：
Oldfield, EH
影响因子：
4.1
作者：
C. Jack;Emre Kokmen;B. Onofrio
通讯作者：
C. Jack;Emre Kokmen;B. Onofrio
I 型 Chiari 畸形继发脊柱侧凸患者颅后窝减压后的空洞消退
影响因子：
2.8
作者：
Wu, Tao;Zhu, Zezhang;Qiu, Yong
通讯作者：
Qiu, Yong