脊柱侧弯合并脊髓纵裂136例的临床特征及骨嵴形态学分析  

The morphological study of split cord malformation and intraspinal bony spur in congenital scoliosis patients

作　　者：曹隽[1] 孙琳[1] 孙保胜[1] 张学军[1] 李承鑫[1] 祁新禹[1] 于凤章[1] 潘少川[1] 

机构地区：[1]首都医科大学附属北京儿童医院骨科,100045

出　　处：《临床小儿外科杂志》2011年第1期12-15,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的 探讨先天性脊柱侧弯合并脊髓纵裂骨嵴在椎管内的形态、节段、位置等形态学特点,提出新的纵裂分型方法,以期指导临床工作.方法 回顾性分析136例先天性脊柱侧弯合并脊髓纵裂患儿的临床资料以及CT、MRI等影像学检查结果.结果 Ⅰ型及Ⅱ型脊髓纵裂在胸腰段的发生率最高,腰段及胸段次之,颈段较少;Ⅰ型脊髓纵裂中椎管内骨嵴的发生节段以腰段最多,其次为胸腰段及胸段,颈段罕见.骨嵴以贯通型多见,存在腹侧型及背侧型,但数量较少.结论 先天性脊柱侧弯患者常合并脊髓纵裂畸形,完善术前CT及MRI等影像学检查有助于更好地了解脊髓纵裂及骨嵴的形态特点,根据骨嵴在椎管内背侧、腹侧或是否贯通进行分类,对脊髓纵裂的病情评估及手术方法 的选择有一定的指导意义.Objective To evaluate the morphological character including intraspinal shape, level and location of split cord malformations （SCM）s and bony spurs （BS）s associated with congenital scoliosis（CS）. Methods CT and MRI scan results of 136 SCM associated with CS patients were retrospectively analyzed. Results Both type Ⅰ and type Ⅱ SCM had the highest incidence presenting in lumbar segments of spine, secondly in thoracolumbar and thoracic segments, the incidence is low in cervical segments; BSs in type Ⅰ SCM have the highest incidence presenting in lumbar segments, the next is thoracolnmbar and thoracic segments, and in cervical is rare. Most BSs is run-through type with few ventral and dorsal type exists. Conclusions There is a high incidence of SCM in CS patients. CT and MRI scan will be beneficial to know the morphological character of SCM and BS Preoperative, and will be helpful to the treatment.

关 键 词：脊柱/畸形 脊髓 椎管闭合不全 

分 类 号：R682.13[医药卫生—骨科学]