视觉在维持姿势稳定中的作用至关重要,和它的损失,无论是先天性的还是获得性的,可以显著影响感觉运动相互作用,导致肌肉骨骼异常和有缺陷的步态模式。本病例报告讨论了视觉障碍之间复杂的相互作用,创伤后脊柱后凸,以及一名79岁失明患者脊柱畸形的发展。该患者在2016年持续了一次简单的跌倒,导致L1压缩性骨折。尽管对骨折进行了保守治疗,进行性脊柱畸形在临床和影像学上都很明显。进一步评估,包括骨愈合的评估,关节突关节成形术,椎间盘退变,和运河妥协,被执行了。患者的步态和姿势异常改变表明视力障碍对姿势稳定性的影响。在通过内分泌学咨询和医疗管理解决骨质疏松症后,患者接受了脊柱后路器械和畸形矫正,导致成功的术后恢复,并恢复到基线功能状态。视觉障碍通过限制感觉输入和提示代偿机制来破坏姿势稳定性,这可能会增加姿势摇摆和不稳定。这种异常步态进一步导致脊柱畸形,对跌倒的恐惧会加剧姿势不稳定,限制流动性。随着时间的推移,持续的姿势失衡导致与脊柱轴相关的持续不对称应力状态的产生,可以进展到脊柱畸形的发展,创造一个自我延续的循环。此案例强调了视觉在姿势稳定性中的重要性以及视觉障碍对脊柱对准的不利影响。视障人士脊柱畸形的发展,尤其是在存在骨质疏松症等危险因素的情况下,强调需要早期干预和姿势训练,以防止不可逆的畸形。关于视障患者脊柱畸形的手术或非手术干预的决定必须考虑多种因素,包括临床症状,外观,疼痛,功能限制,和社会问题。未来的研究应探索有效的干预措施,以改善视力受损者的姿势稳定性并防止脊柱畸形的发展。
The role of vision in maintaining postural stability is crucial, and its loss, whether congenital or acquired, can significantly impact sensory-motor interactions, leading to musculoskeletal abnormalities and defective gait patterns. This
case report discusses the complex interplay between visual impairment, post-traumatic kyphosis, and the development of spinal deformity in a 79-year-old blind patient. The patient sustained a simple fall resulting in an L1 compression fracture in 2016. Despite conservative treatment for the fracture, progressive spinal deformity became evident both clinically and radiographically. Further assessments, including evaluation of bone healing, facet arthroplasty, disc degeneration, and canal compromise, were performed. The patient\'s altered gait and postural abnormalities were indicative of the impact of visual impairment on postural stability. After addressing osteoporosis through endocrinology consultation and medical management, the patient underwent posterior spinal instrumentation and deformity correction, leading to a successful post-operative recovery with a return to baseline functional status. Visual impairment disrupts postural stability by limiting sensory input and prompting compensatory mechanisms, which may increase postural sway and instability. This abnormal gait further contributes to spinal deformities, and the fear of falling can exacerbate postural instability, limiting mobility. Over time, persistent postural imbalance leads to the creation of a state of continual asymmetric stress related to the spinal axis, which can progress to the development of spinal deformities, creating a self-perpetuating cycle. This
case underscores the significance of vision in postural stability and the adverse effects of visual impairment on spinal alignment. The development of spinal deformities in visually impaired individuals, especially in the presence of risk factors like osteoporosis, emphasizes the need for early intervention and postural training to prevent irreversible deformities. Decisions regarding surgical or non-surgical interventions for spinal deformities in visually impaired patients must consider multiple factors, including clinical symptoms, appearance, pain, functional limitations, and social issues. Future research should explore effective interventions for improving postural stability in visually impaired individuals and preventing the development of spinal deformity.