PDF(Pubmed)
Abstract：
UNASSIGNED: Osteogenesis imperfecta (OI) is a rare skeletal disorder characterized by bone fragility and deformities in both paediatric and adult populations. The occurrence of severe spondylolisthesis in OI patients is even more infrequent. However, there is no consensus regarding the optimal treatment approach for OI patients afflicted with severe spondylolisthesis. The selection of surgical procedures and the effective management of postoperative complications present significant challenges in this context.
UNASSIGNED: A 30-year-old male patient diagnosed with OI type IV (Sillence classification) underwent the lumbar laminectomy and postero-lateral fusion due to severe spondylolisthesis (grade Ⅲ). Following the surgery, the patient experienced postoperative screw pullout while on bedrest. However, aside from experiencing back pain, there were no neurological symptoms present. To address this issue, the patient received salvage treatment in the form of cast immobilization combined with bisphosphonates. At the 3-year follow-up, the patient exhibited absence of sciatic nerve pain and reported mild numbness in the lower extremities. Moreover, the patient demonstrated the ability to ambulate a distance exceeding 1500 m. Nevertheless, the persistence of sexual dysfunction was observed.
UNASSIGNED: This study presented the initial instance of surgical complications observed in patients with severe spondylolisthesis and OI. This highlights the importance to exercise meticulous caution and thoroughness when assessing surgical interventions.
UNASSIGNED: In cases where the fixation fails to offer adequate biomechanical stability, the administration of bisphosphonates and robust immobilization remains crucial, even in the presence of complications.
UNASSIGNED: A 30-year-old male patient diagnosed with OI type IV (Sillence classification) underwent the lumbar laminectomy and postero-lateral fusion due to severe spondylolisthesis (grade Ⅲ). Following the surgery, the patient experienced postoperative screw pullout while on bedrest. However, aside from experiencing back pain, there were no neurological symptoms present. To address this issue, the patient received salvage treatment in the form of cast immobilization combined with bisphosphonates. At the 3-year follow-up, the patient exhibited absence of sciatic nerve pain and reported mild numbness in the lower extremities. Moreover, the patient demonstrated the ability to ambulate a distance exceeding 1500 m. Nevertheless, the persistence of sexual dysfunction was observed.
UNASSIGNED: This study presented the initial instance of surgical complications observed in patients with severe spondylolisthesis and OI. This highlights the importance to exercise meticulous caution and thoroughness when assessing surgical interventions.
UNASSIGNED: In cases where the fixation fails to offer adequate biomechanical stability, the administration of bisphosphonates and robust immobilization remains crucial, even in the presence of complications.
摘要：
■成骨不全症（OI）是一种罕见的骨骼疾病，其特征是儿科和成人人群中的骨骼脆性和畸形。OI患者中严重腰椎滑脱的发生甚至更罕见。然而,对于患有严重脊椎前移的OI患者的最佳治疗方法尚无共识。在这种情况下，外科手术的选择和术后并发症的有效管理提出了重大挑战。
■一名30岁的男性患者，诊断为OIIV型（Sillence分级），由于严重的腰椎滑脱（Ⅲ级），接受了腰椎椎板切除术和后外侧融合。手术后,患者在卧床休息时经历了术后螺钉拔出。然而,除了背部疼痛，没有出现神经症状.为了解决这个问题，患者接受了石膏固定联合双膦酸盐的抢救治疗.在3年的随访中，患者表现为没有坐骨神经疼痛，并报告下肢轻度麻木。此外，患者表现出行走超过1500米的能力。尽管如此，观察到性功能障碍的持续性.
■本研究提供了严重腰椎滑脱和OI患者手术并发症的初步实例。这凸显了在评估手术干预措施时要谨慎谨慎和彻底的重要性。
■如果固定无法提供足够的生物力学稳定性，双膦酸盐的给药和坚固的固定仍然至关重要，即使存在并发症。
■一名30岁的男性患者，诊断为OIIV型（Sillence分级），由于严重的腰椎滑脱（Ⅲ级），接受了腰椎椎板切除术和后外侧融合。手术后,患者在卧床休息时经历了术后螺钉拔出。然而,除了背部疼痛，没有出现神经症状.为了解决这个问题，患者接受了石膏固定联合双膦酸盐的抢救治疗.在3年的随访中，患者表现为没有坐骨神经疼痛，并报告下肢轻度麻木。此外，患者表现出行走超过1500米的能力。尽管如此，观察到性功能障碍的持续性.
■本研究提供了严重腰椎滑脱和OI患者手术并发症的初步实例。这凸显了在评估手术干预措施时要谨慎谨慎和彻底的重要性。
■如果固定无法提供足够的生物力学稳定性，双膦酸盐的给药和坚固的固定仍然至关重要，即使存在并发症。
