BACKGROUND Spondyloepiphyseal dysplasia congenita(SEDC)is a rare autosomal dominant hereditary disease caused by COL2A1 mutations.SEDC primarily involves the skeletal system,with typical clinical manifestations,includ...BACKGROUND Spondyloepiphyseal dysplasia congenita(SEDC)is a rare autosomal dominant hereditary disease caused by COL2A1 mutations.SEDC primarily involves the skeletal system,with typical clinical manifestations,including short stature,hip dysplasia,and spinal deformity.Due to the low incidence of SEDC,there are only a few case reports regarding the surgical treatment of SEDC complicated with spinal deformities.CASE SUMMARY We report a case of a 16-year-old male patient with SEDC.He presented with typical short stature,atlantoaxial dysplasia,scoliosis,and hip dysplasia.Cervical magnetic resonance imaging showed spinal canal stenosis at the atlas level and cervical spinal cord compression with myelopathy.The scoliosis was a right thoracic curve with a Cobb angle of 65°.He underwent atlantoaxial reduction,decompression,and internal fixation from C1–C2 to relieve cervical myelopathy.Three months after cervical surgery,posterior correction surgery for scoliosis was performed from T3 to L4.Scoliosis was corrected from 66°to 8°and remained stable at 2-year follow-up.CONCLUSION This is the first case report of a patient with SEDC who successfully underwent surgery for atlantoaxial dysplasia and scoliosis.The study provides an important reference for the surgical treatment of SEDC complicated with spinal deformities.展开更多
BACKGROUND Spontaneous cerebrospinal fluid(CSF)leaks associated with cervical spondylosis are rare.To our knowledge,only a few cases have been reported in which treatment is challenging and varies from case to case.He...BACKGROUND Spontaneous cerebrospinal fluid(CSF)leaks associated with cervical spondylosis are rare.To our knowledge,only a few cases have been reported in which treatment is challenging and varies from case to case.Here,we review the literature and describe the surgical treatment of a 70-year-old woman who presented with a CSF leak due to a cervical spine spur.CASE SUMMARY A 70-year-old female patient who was treated for a cerebral infarction,presented with complains of weakness in the right lower extremity and a feeling of stepping on cotton.The patient underwent regular neck massage and presented with neck and right shoulder pain radiating to the right upper extremity one-month ago.Magnetic resonance imaging showed a strip of leaking cerebrospinal fluid posterior to the C1-4 vertebrae,and computed tomography showed a“sickleshaped”disc prolapse with calcification in C4/5.We chose to perform an anterior cervical discectomy.When the prolapsed C4/5 disc was scraped,clear fluid leakage was observed,and exploration revealed a 1 mm diameter rupture in the anterior aspect of the dura mater,which was compressed continuously with cotton patties,with no significant cerebrospinal fluid leakage after 1 h.CONCLUSION Three months after surgery,the patient was asymptomatic and follow-up imaging demonstrated complete resolution.展开更多
Objective To discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease. Methods From January 2004 to December 2008,79 cases with the coexistence of cervic...Objective To discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease. Methods From January 2004 to December 2008,79 cases with the coexistence of cervical,thoracic展开更多
Objective:Apparently, scoliosis occurs in approximately one-third of patients with Charcot-Marie-Tooth disease. Little is known about the response of these curves to treatment. The purpose of this study was to evaluat...Objective:Apparently, scoliosis occurs in approximately one-third of patients with Charcot-Marie-Tooth disease. Little is known about the response of these curves to treatment. The purpose of this study was to evaluate the results of spinal surgery in these peculiar patients. Methods: We retrospectively evaluated the results of spinal surgery in eight patients who had scoliosis due to clinically and electrophysiologically proven Charcot-Marie-Tooth disease. Radiographs were reviewed. The location and direction of the curve pattern, the age at the time of surgery, type of surgery, number of levels fused, instrumentations used, intra or postoperative complications, and results and need for reoperation were recorded. Results: Eight patients associated with Charcot-Marie-Tooth disease who underwent scoliotic surgery were identified. The average age and curve at the time of surgery were 21.1 years and 56.4° respectively. 62.5% of the curves had left thoracic component and more than one third was associated with thoracic hyperkyphosis. Long posterior spinal fusion was performed most often, with an average of 11.5 spinal segments fused. Instrumentation was used in all posterior fusions. At an average of 39 months (range, 24 to 72 months) postoperatively, the fusion appeared to be solid in all patients. Conclusion: Scoliosis in patients with Charcot-Marie-Tooth disease differs from that in patients with idiopathic scoliosis in regarding to the etiology and the prevalence of thoracic hyperkyphosis, but the surgical management appears to be similar. Spondylodesis does not appear to be associated with a high rate of complications.展开更多
Background Although previous reports had reported the use of temporary internal distraction as an aid to correct severe scoliosis,two-stage surgery strategy （less invasive internal distraction followed by posterior c...Background Although previous reports had reported the use of temporary internal distraction as an aid to correct severe scoliosis,two-stage surgery strategy （less invasive internal distraction followed by posterior correction and instrumentation） has never been reported in the treatment of patients with severe spinal deformity.This study aimed to report the results of the surgical treatment of severe scoliosis and kyphoscoliosis by two-stage and analyse the safety and efficacy of this surgical strategy in the treatment of severe spinal deformities.Methods A total of 15 patients with severe scoliosis,kyphoscoliosis or kyphosis who underwent two-stage surgeries （less invasive internal distraction followed by posterior correction and instrumentation） were studied based on hospital records.Pretreatment radiographs and radiographs taken after first surgery （internal distraction by two small incisions）,before second surgery （posterior correction,instrumentation and fusion）,one week after second surgery and final follow-up were measured.Subjects were analyzed by age,gender,major coronal curve magnitude,flexibility of major curve,major sagittal curve magnitude before first surgery,after first surgery,before second surgery,after second surgery and at final follow-up.Complications related to two-stage surgeries were noted in each case.Results The average major curve magnitude was 129.4° （range,95° to 175°）,reduced 58.9° or 45.4% after first stage surgery and reduced 30.6° or 24.6% after second stage surgery.The loss of correction during the interval between two surgeries was 7.1%.The total major coronal curve correction was 81.4°or 62.9%.At the final follow up,the average loss of correction of major coronal curve was 3.9° and the final average correction rate was 59.7%.The average major sagittal curve magnitude was 80.3° （range,30° to 170°）,and the total major sagittal curve correction was 48.2°.Loss of correction averaged 4.0° for major sagittal curve and the final correction averaged 42.2°.Clinical complications were noted in the peri-operative and long-term periods.Conclusions Two-stage surgery was a safe and effective surgical strategy in this difficult population.Using two-small-incision technique,the first stage surgery was less invasive.No permanent neurologic deficit was noted in this series.展开更多
基金National Natural Science Foundation of China,No.81974354 and No.82230083.
文摘BACKGROUND Spondyloepiphyseal dysplasia congenita(SEDC)is a rare autosomal dominant hereditary disease caused by COL2A1 mutations.SEDC primarily involves the skeletal system,with typical clinical manifestations,including short stature,hip dysplasia,and spinal deformity.Due to the low incidence of SEDC,there are only a few case reports regarding the surgical treatment of SEDC complicated with spinal deformities.CASE SUMMARY We report a case of a 16-year-old male patient with SEDC.He presented with typical short stature,atlantoaxial dysplasia,scoliosis,and hip dysplasia.Cervical magnetic resonance imaging showed spinal canal stenosis at the atlas level and cervical spinal cord compression with myelopathy.The scoliosis was a right thoracic curve with a Cobb angle of 65°.He underwent atlantoaxial reduction,decompression,and internal fixation from C1–C2 to relieve cervical myelopathy.Three months after cervical surgery,posterior correction surgery for scoliosis was performed from T3 to L4.Scoliosis was corrected from 66°to 8°and remained stable at 2-year follow-up.CONCLUSION This is the first case report of a patient with SEDC who successfully underwent surgery for atlantoaxial dysplasia and scoliosis.The study provides an important reference for the surgical treatment of SEDC complicated with spinal deformities.
文摘BACKGROUND Spontaneous cerebrospinal fluid(CSF)leaks associated with cervical spondylosis are rare.To our knowledge,only a few cases have been reported in which treatment is challenging and varies from case to case.Here,we review the literature and describe the surgical treatment of a 70-year-old woman who presented with a CSF leak due to a cervical spine spur.CASE SUMMARY A 70-year-old female patient who was treated for a cerebral infarction,presented with complains of weakness in the right lower extremity and a feeling of stepping on cotton.The patient underwent regular neck massage and presented with neck and right shoulder pain radiating to the right upper extremity one-month ago.Magnetic resonance imaging showed a strip of leaking cerebrospinal fluid posterior to the C1-4 vertebrae,and computed tomography showed a“sickleshaped”disc prolapse with calcification in C4/5.We chose to perform an anterior cervical discectomy.When the prolapsed C4/5 disc was scraped,clear fluid leakage was observed,and exploration revealed a 1 mm diameter rupture in the anterior aspect of the dura mater,which was compressed continuously with cotton patties,with no significant cerebrospinal fluid leakage after 1 h.CONCLUSION Three months after surgery,the patient was asymptomatic and follow-up imaging demonstrated complete resolution.
文摘Objective To discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease. Methods From January 2004 to December 2008,79 cases with the coexistence of cervical,thoracic
基金ACKNOWLEDGEMENTS The authors wish to thank Toosi KZ for her help in reviewing and copyediting this paper.
文摘Objective:Apparently, scoliosis occurs in approximately one-third of patients with Charcot-Marie-Tooth disease. Little is known about the response of these curves to treatment. The purpose of this study was to evaluate the results of spinal surgery in these peculiar patients. Methods: We retrospectively evaluated the results of spinal surgery in eight patients who had scoliosis due to clinically and electrophysiologically proven Charcot-Marie-Tooth disease. Radiographs were reviewed. The location and direction of the curve pattern, the age at the time of surgery, type of surgery, number of levels fused, instrumentations used, intra or postoperative complications, and results and need for reoperation were recorded. Results: Eight patients associated with Charcot-Marie-Tooth disease who underwent scoliotic surgery were identified. The average age and curve at the time of surgery were 21.1 years and 56.4° respectively. 62.5% of the curves had left thoracic component and more than one third was associated with thoracic hyperkyphosis. Long posterior spinal fusion was performed most often, with an average of 11.5 spinal segments fused. Instrumentation was used in all posterior fusions. At an average of 39 months (range, 24 to 72 months) postoperatively, the fusion appeared to be solid in all patients. Conclusion: Scoliosis in patients with Charcot-Marie-Tooth disease differs from that in patients with idiopathic scoliosis in regarding to the etiology and the prevalence of thoracic hyperkyphosis, but the surgical management appears to be similar. Spondylodesis does not appear to be associated with a high rate of complications.
文摘Background Although previous reports had reported the use of temporary internal distraction as an aid to correct severe scoliosis,two-stage surgery strategy （less invasive internal distraction followed by posterior correction and instrumentation） has never been reported in the treatment of patients with severe spinal deformity.This study aimed to report the results of the surgical treatment of severe scoliosis and kyphoscoliosis by two-stage and analyse the safety and efficacy of this surgical strategy in the treatment of severe spinal deformities.Methods A total of 15 patients with severe scoliosis,kyphoscoliosis or kyphosis who underwent two-stage surgeries （less invasive internal distraction followed by posterior correction and instrumentation） were studied based on hospital records.Pretreatment radiographs and radiographs taken after first surgery （internal distraction by two small incisions）,before second surgery （posterior correction,instrumentation and fusion）,one week after second surgery and final follow-up were measured.Subjects were analyzed by age,gender,major coronal curve magnitude,flexibility of major curve,major sagittal curve magnitude before first surgery,after first surgery,before second surgery,after second surgery and at final follow-up.Complications related to two-stage surgeries were noted in each case.Results The average major curve magnitude was 129.4° （range,95° to 175°）,reduced 58.9° or 45.4% after first stage surgery and reduced 30.6° or 24.6% after second stage surgery.The loss of correction during the interval between two surgeries was 7.1%.The total major coronal curve correction was 81.4°or 62.9%.At the final follow up,the average loss of correction of major coronal curve was 3.9° and the final average correction rate was 59.7%.The average major sagittal curve magnitude was 80.3° （range,30° to 170°）,and the total major sagittal curve correction was 48.2°.Loss of correction averaged 4.0° for major sagittal curve and the final correction averaged 42.2°.Clinical complications were noted in the peri-operative and long-term periods.Conclusions Two-stage surgery was a safe and effective surgical strategy in this difficult population.Using two-small-incision technique,the first stage surgery was less invasive.No permanent neurologic deficit was noted in this series.
