Scheuermann's Kyphosis 的新手术适应症。

IF 2 Q2 ORTHOPEDICS
Jason J Haselhuhn, Kari Odland, Paul Brian O Soriano, Kristen E Jones, David W Polly
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引用次数: 0

摘要

Scheuermann 脊柱弯曲可以通过手术治疗来恢复正常的矢状排列。胸椎弯曲度大于 70° 的患者通常需要进行手术治疗。然而,已达到腰椎过度前凸代偿自然极限的患者有加速退化的风险。这可以通过比较站立中立位X光片和仰卧位伸展位X光片上的腰椎前凸来确定。与中立位相比,患者在伸展时的腰椎前凸最小,脊柱棘突突出,或站立时的腰椎前凸大于尝试伸展时的腰椎前凸,这表明患者的腰椎代偿已达到最大程度。我们介绍了一例患有谢尔曼椎体后凸的青少年男孩,他的过度前凸代偿储备已达到极限。随后,他接受了 T4 至 L2 后路脊柱融合术和 T7 至 T11 Ponte Smith-Petersen 二级截骨术。他对手术的耐受性良好,术中未出现并发症或神经监测变化。随访5个月后,患者的情况一直很好,可以正常活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Surgical Indication for Scheuermann's Kyphosis.

Scheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This can be determined by comparing lumbar lordosis on standing neutral radiographs and supine extension radiographs. Minimal additional lordosis in extension compared with neutral, abutment of the spinous processes, or greater lumbar lordosis standing than with attempted extension suggest the patient is maximally compensated. We present a case of an adolescent boy with Scheuermann kyphosis who had reached the limit of his hyperlordosis compensation reserve. He subsequently underwent a T4 to L2 posterior spinal fusion with T7 to T11 Ponte Smith-Petersen grade two osteotomies. He tolerated the procedure well with no intraoperative complications or neuromonitoring changes. The patient has continued to do well and progressed to normal activity at 5-month follow-up.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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