Adult thoracolumbar or lumbar scoliosis with Chiari malformation and syringomyelia: a retrospective study of correction and fusion strategies

作者：Zhang, Hong-Qi^*; Deng, Ang; Liu, Shao-Hua; Chen, Ling-Qiang; Guo, Chao-Feng; Tang, Ming-Xing; Wu, Jian-Huang; Liu, Jin-Yang; Chen, Jing

来源：Archives of Orthopaedic and Trauma Surgery, 2011, 131(4): 475-480.

DOI：10.1007/s00402-010-1151-y

• Scoliosis
• Chiari malformation
• Syringomyelia
• Correction
• Fusion

Retrospective case series.
To study the correction and fusion strategies for adult thoracolumbar or lumbar scoliosis with Chiari malformation and syringomyelia by using posterior pedicle screw instrumentation (PPSI).
Surgical intervention for Chiari malformation and syringomyelia before surgical correction of scoliosis has been reported; however, there are no clinical trials for the PPSI-based correction and fusion procedures used in these patients.
From 2002 to 2009, 13 adult patients (mean age, 34.9 years) suffering from thoracolumbar or lumbar scoliosis with Chiari malformation and syringomyelia underwent correction and fusion by using PPSI. Preoperative, postoperative, and final follow-up coronary Cobb angle, correction rate, pelvic obliquity (PO), apical vertebral rotation (AVR), apical vertebral translation (AVT), trunk shift (TS), sagittal thoracic kyphosis angle, and lumbar lordosis angle were analyzed on radiographs.
The preoperative and postoperative mean coronary Cobb angle was from 46.8A degrees to 9.2A degrees, correction rate was 80.7%, PO from 9.9A degrees to 3.2A degrees, AVR from 1.9A degrees to 0.3A degrees, AVT from 3.6 to 0.8 cm, TS from 16.8 to 1.6 cm, sagittal thoracic kyphosis angle from 18.2A degrees to 23.5A degrees, and lumbar lordosis angle was from 37.4A degrees to 41.8A degrees. The mean follow-up period was 35.2 months (range, 24-50 months). There were no obvious pseudoarticulations or loss of correction and trunk equilibrium at the final follow-up; no aggravation of the original neural symptoms or new irreversible neural injury was observed.
In patients with mild or moderate adult thoracolumbar or lumbar scoliosis with Chiari malformation and syringomyelia, the correction and fusion by using PPSI can yield a satisfactory clinical effect.

• 出版日期2011-4
• 单位中南大学