儿童先天性颈椎畸形的诊断和治疗进展  

Diagnoses and treatments of congenital cervical spinal deformities in children

作　　者：罗焱中 张学军[1] Luo Yanzhong;Zhang Xuejun(Department of Orthopedics,Affiliated Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院骨科,北京100045

出　　处：《临床小儿外科杂志》2023年第11期1001-1007,共7页Journal of Clinical Pediatric Surgery

基　　金：中央高水平医院临床科研业务费资助(2022-PUMCH-D-004)

摘　　要：儿童颈椎畸形发病率较低,通常为先天性发育畸形。复杂多样的病因以及散在发病的特点使得儿童先天性颈椎畸形的系统性分类、分型更加困难;在对这些患儿进行诊治时,很难完全掌握准确的畸形情况,对患儿的畸形发展预测和精准随访干预也很难进行。根据颈椎畸形的手术治疗方式,目前常以上颈椎畸形和颈椎后凸畸形进行分类。上颈椎畸形若存在显著的寰枕或寰枢关节不稳合并高位颈脊髓压迫症状,应积极行内固定融合手术,以免造成不可逆的神经损伤。颈椎后凸畸形一旦发现应密切随诊,部分后凸畸形随着颈后肌肉生长发育有自发矫正的趋势,当后凸进行性加重或产生神经压迫症状时应积极进行手术治疗。根据颈椎畸形的病因学分类,目前研究较深入的是各类综合征疾病,多种综合征疾病均可合并上颈椎发育异常或后凸畸形,但其致病机理和临床特点各异。因此,本文拟对儿童颈椎畸形的流行病学、常见病因分类及诊治研究进展进行评述。Cervical spine deformities are rare and the incidence rate remains low in children.Usually the characteristics of complex etiology and a sporadic onset make it more difficult to systematically classify congenital cervical spine deformities.And it is difficult to fully acquire accurate information about the deformity.And it is also problematic to evaluate the prognosis of deformity development and apply precise follow-up interventions.With greater popularization of molecular biology and genetic diagnosis,a large variety of congenital cervical deformities have been successfully managed.There are still some controversies of proper treatments.This review focused upon the epidemiological features,common etiologies and managements of cervical spine deformities in children.

关 键 词：颈椎 先天畸形 外科手术 儿童 

分 类 号：R726.8[医药卫生—儿科]