Spondylolysis in children who have osteopetrosis
Spondylolysis in children who have osteopetrosis
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DOI：
10.2106/00004623-199711000-00010
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发表时间：
1997-11-01
影响因子：
5.3
通讯作者：
Collett, V
中科院分区：
文献类型：
--
作者：
Martin, RP;Deane, RH;Collett, V
7名因石骨症接受治疗的儿童中有5名患有颈椎峡部裂或腰椎峡部裂，或两者兼而有之。3名儿童仅腰椎峡部裂，1名仅颈椎峡部裂，1名两个区域均峡部裂。在诊断为椎弓峡部裂后，对这5名患者进行了平均41个月（范围：16 ~ 72个月）的随访。其中3例患者采用腰骶束衣或胸腰骶矫形器进行非手术治疗。这三名患者中的一名也有颈椎峡部裂和颈部疼痛，接受了后路颈椎关节融合术，但出现了稳定的假关节。在最近的随访-np评估中，所有5名患者均无症状，尽管有2名患者有长期的腰痛。我们认为，颈椎或腰椎峡部裂在儿童石骨症中的发生率比以前认识到的要高。这类儿童的椎弓峡部裂常伴有腰痛。这些症状可能是导致常染色体显性石骨症诊断的最初表现的一部分。在1例患者中，腰椎峡部裂在就诊时伴有I级脊椎前移。这是唯一一名发生滑倒的患者，滑倒没有进展。
Five of seven children who were managed for osteopetrosis had either cervical spondylolysis or lumbar spondylolysis, or both. Three of the children had lumbar spondylolysis only, one had cervical spondylolysis only, and one had spondylolysis in both areas. The five patients were followed for an average of forty-one months (range, sixteen to seventy-two months) after the diagnosis of spondylolysis was made. Three of the patients were managed non-operatively with a lumbosacral corset or a thoracolumbosacral orthosis. One of these three patients, who also had cervical spondylolysis and neck pain, had a posterior cervical arthrodesis, but a stable pseudarthrosis developed. All five patients were asymptomatic at the latest follow-np evaluation, although two had had prolonged low-back pain.We believe that cervical or lumbar spondylolysis is present in children who have osteopetrosis more often than has been previously recognized. The spondylolysis in such children often is associated with low-back pain. The symptoms may be part of the initial presentation that leads to the diagnosis of autosomal dominant osteopetrosis. In one patient, the spondylolysis was associated with a grade-I spondylolisthesis at the time off presentation. This was the only patient who had a slip, and the slip did not progress.