脊柱裂所致足部畸形（附60例报告）

The Management of Foot Deformities Caused by Spina Bifida-A Report of 60 Cases

作者对１９７５～１９９２年间收治的脊柱裂所致足部畸形６０例进行临床总结，认为本病单纯依赖手术治疗，年龄愈小疗效愈差。７岁以下的患儿应以支具等保守治疗为主。本病的形成机制为脊髓神经在椎管内外的广泛粘连，脊柱骨的生长速度快于脊髓，神经牵拉致伤，肌肉麻痹所致。如发现脊柱背中线的腰骶部有局限性皮肤凹陷、色素沉着或囊性膨出物及小腿、足部有局限性皮肤感觉障碍、脊柱Ｘ线片见有椎弓、椎板部分骨缺损即可确诊。根据畸形程度、肌力、年龄等选择肌腱移位、延长、切骨矫形术等。

AbstractThe authors reviewed 60 cases of foot deformities caused by spina bifida encountered ffom 1975 to 1992.The results of surgical corrections were not as satisfactorymthe younger age group.For the patients below 7 yearsof age,the treatment should be mainly conservative,usingbraces or orthopaedic appliancs.The mechanism of theseconditions is due to extensive adhesions of the spinalnerves inside and outside of the spinal canal. Stretching ofthe nerve fibers and muscular paralysis occurred as a re-sult of the more rapid growth of the bony canal than thespinal cord.The diagncois of this condition can be con-firmed by x-ray findings of defec ts of the podicles and thelaminae of the spinal column,in association with local der-mal pitting and pigmentation over the lumbar-sacral regionor cystic protrusion with paraesthesia over the fcot andankle, Tendon transplantation,tendon lengthening,and os-teotomies are the procedures to be selected according to thedegree of the deformities,the muscular status and the age of the patients.