Segmental Spinal Aplasia: Anatomical Variations and Treatment Insights.

Autor:	Sergeenko Pavlova OM; Division of Spinal Surgery, Department of Neurosurgeon, Spine Surgeon, Ilizarov Center, Kurgan, Russia., Savin DM; Division of Spinal Surgery, Department of Neurosurgeon, Spine Surgeon, Ilizarov Center, Kurgan, Russia., Burtsev AV; Orthopedic Surgeon, Ilizarov Center, Kurgan, Russia., Saifutdinov MS; Division of Spinal Surgery, Department of Neurophysiologist, Ilizarov Center, Kurgan, Russia., Ryabykh SO; Orthopedic Surgeon, N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Kurgan, Russia., Evsyukov AV; Head of Division of Spinal Surgery, Orthopedic Surgeon, Department of Neurosurgeon, Ilizarov Center, Kurgan, Russia.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Jun 12, pp. 21925682241263269. Date of Electronic Publication: 2024 Jun 12.
DOI:	10.1177/21925682241263269
Abstrakt:	Study Design: Retrospective Cohort Study. Objective: The study aimed to analyze anatomical variants of segmental spinal aplasia (SSA) and investigate factors influencing surgical treatment outcomes, with a specific focus on the incidence of complications. Methods: The study focused on patients with SSA treated at a single medical center, with over two years of follow-up. Neurological function changes were evaluated using the modified Japanese Orthopedic Scale (mJOA). Functional independence was measured using the Functional Independence Measure (FIM/WeeFIM) scale, and complications, well-being, and reoperation instances were documented. Statistical analyses used ANOVA and Kruskal-Wallis test. Results: The predominant localization of SSA in 36 own cases occurs near or at the level of the thoracolumbar junction, often accompanied by significant spinal cord narrowing and a low position of the conus medullaris. Additionally, it frequently presents with aplasia of the lower ribs. Cervicothoracic SSA was more commonly associated with segmentation disorders ( P = .04). The most common early complications were wound problems (17%) and neurological deterioration (17%); the most common late complications were: non-fusion (34%); 38% of patients required one or more revision surgery. The type, age of surgery, level of surgery, and initial neurological deficient did not significantly influence the incidence of complications or neurological and functional outcomes. Conclusion: SSA, a range of anomalies appearing early in childhood, progresses gradually. Surgery involves vertebrectomy followed by interbody fusion and screw fixation, guided by neurophysiological monitoring. Surgery is recommended for worsening neurological symptoms, but conservative options like bracing can be considered, due to a high risk of complications. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. The authors declare no conflict of interest in this work.
Databáze:	MEDLINE
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