常见和轻微的出生缺陷,如隐性脊柱裂(SBO)和腰骶移行椎骨(LSTV),在很大程度上是无症状和被忽视的。然而,对于临床医生来说,重要的是要考虑它们对脊柱稳定性的潜在影响.神经肌肉脊柱侧凸(NMS)是脊柱的异常横向弯曲,会影响患有先前存在的神经肌肉疾病的儿童,这些疾病通常难以控制。本病例报告的目的是描述双腰骶部异常与复杂NMS的关联。一名12岁的男孩被他的母亲带到脊医那里进行咨询,并可能照顾男孩的背部疼痛,进行性脊柱侧弯,以及在过去12个月中迅速恶化的长期行走异常。他的母亲说,自从他开始学习走路以来,病人一直用左脚的球走路,而不是在脚跟上增加体重。他从小就拜访了几位儿科医生和神经科医生。没有人能够解决他的问题。X线照片显示右侧胸腰段Cobb角20°曲线,左骨盆倾斜,L5和S1的裂隙,以及L5的横突与双侧a骨的关节。患者被诊断为NMS和功能性腿长度差异,归因于SBO和L5水平的LSTV。使用多模式脊椎治疗和足部矫形器。经过18个月的干预,正常的脊柱曲线,脚跟到脚趾的步态,并成功恢复姿势平衡。迄今为止,关于SBO和LSTV对腰骶脊柱的影响的报道很少。这篇文章将有助于更好地了解这些出生缺陷的潜在影响,以及它们将对生长的脊柱产生的相当大的后果,因此,可能有助于减轻他们的影响。
Common and minor birth defects, such as spina bifida occulta (SBO) and lumbosacral transitional vertebra (LSTV), are largely asymptomatic and overlooked. However, it is important for clinicians to consider their potential impacts on spinal stability. Neuromuscular scoliosis (NMS) is an abnormal lateral curvature of the spine that affects children with pre-existing neuromuscular conditions that are often complex to manage. The purpose of this
case report is to describe the association of dual lumbosacral anomalies with complicated NMS. A 12-year-old boy was brought to the chiropractor by his mother for a consultation and possible care for the boy\'s back pain, progressive scoliosis, and long-standing walking abnormality that worsened quickly in the past 12 months. His mother stated that the patient walked on the balls of his left foot instead of putting weight on the heel ever since he started learning to walk. He had visited several pediatricians and neurologists since childhood. No one had been able to solve his problems. Radiographs showed right thoracolumbar curve of Cobb angle 20°, left pelvic obliquity, a cleft in the L5 and S1, and articulation of the transverse processes of L5 with the bilateral sacral alae. The patient was diagnosed with NMS and functional leg length discrepancy attributed to SBO and a LSTV at L5 level. Multimodal chiropractic care and foot orthotics were used. After 18 months of interventions, normal spinal curve, heel-to-toe gait, and posture balance were retrieved successfully. To date, few
reports have been published on the impacts of SBO along with LSTV upon the lumbosacral spine. This article will allow a better understanding of the potential impacts of these birth defects and considerable consequences they would have on the growing spine and, therefore, may help to alleviate their impacts.