在患有古典性 Amyoplasia 和一般性 Arthrogryposis 的患者中脊柱融合
Dietrich Riepen1, Emily E Lachmann2, Brian Wahlig3
1UT Southwestern Medical Center.
Journal of pediatric orthopedics
|July 28, 2023
概括
脊柱融合在关节形多发性先天性 (AMC) 患者的脊柱结合症中具有很高的并发症率,特别是在前后脊柱融合 (ASF/PSF) 中. 深度感染是常见的并发症,曲线的纠正往往是温和的.
科学领域:
- 整形外科 整形外科 整形外科
- 儿科脊柱手术 儿科脊柱手术
- 脊椎病管理 脊椎病管理
背景情况:
- 综合性先天性关节缩 (AMC) 涉及影响多个关节的关节收缩.
- 这项研究重点研究了古典肌瘤和一般AMC患者的脊髓融合结果.
- 在AMC患者中,脊柱形,如脊柱脊椎病,可能会发生.
研究的目的:
- 为了评估脊髓融合的结果,在患有经典肌和一般性关节形症的患者.
- 为了比较后脊融合 (PSF) 和前后脊融合 (ASF/PSF) 之间的并发症率和手术结果.
主要方法:
- 对经过初级终极脊髓融合 (1990-2017年) 的古典肌瘤和一般AMC患者的回顾性审查.
- 排除患有远端/综合征性AMC和增长缓慢仪器的患者.
- 在术后并发症中使用修改后的Clavien-Dindo-sink (MCDS) 分类.
主要成果:
- 15名患者符合分析的纳入标准 (9名PSF,6名ASF/PSF).
- ASF/PSF患者年轻,ASA状态较高,手术时间较长,手术前变形较大.
- 仅PSF患者的11%发生并发症,而ASF/PSF患者的100%发生并发症,最常见的是深层感染 (45%).
- 对于PSF,平均冠状的纠正为48%,对于ASF/PSF,平均纠正为28%.
结论:
- 在AMC患者的脊柱融合与高并发症率有关.
- 前后脊柱融合 (ASF/PSF) 导致并发症和重复手术的发生率显著提高.
- 深层感染是一种常见的并发症,冠状平面曲线校正的程度通常是有限的.
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