MYELOMENINGOCELE AT THE SACRAL LEVEL - LONG-TERM OUTCOMES IN ADULTS
MYELOMENINGOCELE AT THE SACRAL LEVEL - LONG-TERM OUTCOMES IN ADULTS
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DOI：
10.2106/00004623-199409000-00003
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发表时间：
1994-09-01
影响因子：
5.3
通讯作者：
RICE, JC
中科院分区：
文献类型：
--
作者：
BRINKER, MR;ROSENFELD, SR;RICE, JC
我们回顾了 36 名骶骨脊髓脊膜膨出患者的长期结果，这些患者的平均年龄为 29 岁（范围为 19 至 51 岁）。我们在我们的机构中对患者进行平均十年的跟踪（范围从一年到三十三年）；然而，所有患者从出生起的医疗记录都是可以获得的。我们发现这组患者中的 35 名患者中有 11 名最初是社区步行者，其中 11 名患者的行走能力下降，而不是达到预期的结果，即这组患者的功能得以维持。截至最近一次随访检查时，五名已成为家庭步行者，两名为非功能性步行者，四名为非步行者。一名最初是家庭步行者的患者在最近一次随访检查时已不再能够步行。 截至最近一次随访检查，33 名患者总共接受了 371 次骨科手术。手术包括肌腱手术；截骨术；软组织松解、转移和清创；截肢； 14 名患者发现跖屈度下降，15 名患者足底感觉下降。分别有 27 名和 23 名患者出现跖骨头和足跟足底表面的皮肤破损和软组织感染，这与足底感觉缺失有关。 15 名患者患有累及下肢的骨髓炎。 11 名患者总共接受了 14 次截肢：5 名涉及一根或更多脚趾，四名涉及一根或更多趾骨，两名是赛姆截肢，三名是膝下截肢。
We reviewed the long-term outcome of thirty-six patients who had a myelomeningocele at the sacral level and whose average age was twenty-nine years (range, nineteen to fifty-one years). The patients we:re followed at our institution for an average of ten years (range, one to thirty-three years); however, the medical records from birth on were available for all of the patients. Instead of the expected outcome that function had been maintained in this group of patients, we found a decline in the ability to walk of eleven of the thirty-five patients,who had been community ambulators initially. At the time of the most recent follow-up examination, five had become household ambulators, two were non-functional ambulators, and four were non-ambulators. The one patient who initially had been a household ambulator was a non-ambulator at the time of the most recent follow-up examination.By the most recent follow-up examination, thirty-three patients had had a total of 371 orthopaedic procedures. The procedures included tendinous procedures; osteotomies; soft-tissue releases, transfers, and debridements; amputations; and arthrodeses of the lower extremities or spine.A decrease in plantar flexion was found in fourteen patients and a decrease in plantar sensation, in fifteen. Breakdown of the skin and soft-tissue infections on the plantar surface of the metatarsal heads and of the heel were seen in twenty-seven and twenty-three patients, respectively, and were related to the absence of plantar sensation. Fifteen patients had osteomyelitis involving the lower extremity. Eleven patients had had a total of fourteen amputations: five involved one toe or more, four involved one ray or more, two were Syme amputations, and three were below-the-knee amputations.