先天性脊柱侧凸患者中的脊髓畸形和脊椎畸形

目的:探讨先天性脊柱侧凸患者的各类脊髓畸形与脊椎畸形之间的关系。方法:对我院2003年～2005年收治的211例已确诊的先天性脊柱侧凸患者的临床资料进行回顾性分析,统计先天性脊柱侧凸患者脊髓畸形、脊椎畸形的发生率及其好发部位,观察两者间的关系。结果:211例先天性脊柱侧凸患者中脊髓畸形44例(20.85%),其中脊髓空洞症25例次(11.85%),脊髓纵裂30例次(14.22%),马尾终丝栓系28例次(13.27%),低位圆锥12例次(5.69%),其他类型少见,多种畸形常并发存在;脊髓畸形好发于脊柱胸段、胸腰段、腰段、腰骶段。44例伴有脊髓畸形的先天性脊柱侧凸病例中不良分节34例(77.27%),孤立性半椎体1例(2.27%),非孤立性半椎体21例(47.73%),脊柱裂30例(68.18%),混合型41例(93.18%);脊椎畸形好发于脊柱胸段、腰段、腰骶段。结论:先天性脊椎畸形常合并脊髓畸形,总体上脊髓畸形与脊椎畸形的好发部位相似,但各种脊髓畸形、脊椎畸形间缺少显著的、特定的对应关系。

Incidence and significance of spinal cord malformation and vertebral deformity in congenital scoliosis

Objective:To investigate the internal relation between each kind of spinal cord malformation and vertebral deformity in the congenital scoliosis(CS).Method:The imaging information of 211 hospitalized patients that were diagnosed as congenital scoliosis in our hospital between 2003 and 2005 were evaluated retrospectively.The incidence of spinal cord malformation and vertebral deformity,predilection site of each kind of spinal cord malformation and vertebral deformity were measured respectively.Result:There were 44 cases(20.85%) with spinal cord malformation in 211 patients with CS,which includes 25 cases(11.85%) with syringomyelia,30 cases(14.22%) with diastomyelia,28 cases(13.27%) with tethering of cauda equina.Some of these malformations were often found to coexist.Spinal cord malformation usually appeared in the thoracic segment,thoraco-lumbar segment,lumber segment and lumber-sacral segment of spine.There were 34 cases(77.27%) with failure of segmentation,1 case(2.27%) with solitary hemivertebrae,21 cases(47.73%) with multiple hemivertebrae,30 cases(68.18%) with cleft vertebra,41 cases(93.18%) with mixed vertebral deformity.Vertebral deformity usually was detected in the thoracic segment,lumber segment and lumber-sacral segment of spine.Conclusion:The congenital vertebral deformity usually accompanies with the spinal cord malformation.In total,it is similar on predilection sites between spinal cord malformation and vertebral deformity,however no significant specific relations among all kinds of the above anomalies exist.