[1]于潼,张智海△,张振南,等.头环重力牵引治疗脊髓性肌肉萎缩症性脊柱侧凸的临床疗效分析[J].中国中医骨伤科杂志,2023,31(06):56-60.[doi:10.20085/j.cnki.issn1005-0205.230610]
　YU Tong,ZHANG Zhihai,ZHANG Zhennan,et al.The Analysis of Clinical Efficacy of Halo Gravity Traction on the Treatment of Spinal Muscular Atrophy Tyndrome Scoliosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(06):56-60.[doi:10.20085/j.cnki.issn1005-0205.230610]
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头环重力牵引治疗脊髓性肌肉萎缩症性脊柱侧凸的临床疗效分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年06期
页码:
56-60
栏目:
临床报道
出版日期:
2023-06-15

文章信息/Info

Title:
The Analysis of Clinical Efficacy of Halo Gravity Traction on the Treatment of Spinal Muscular Atrophy Tyndrome Scoliosis
文章编号:
1005-0205(2023)06-0056-05
作者:
于潼1; 张智海1△; 张振南2; 李玉彬1; 韩菲1
1中国中医科学院广安门医院骨科(北京,100053)
2中国中医科学院广安门医院医务处
Author(s):
YU Tong1; ZHANG Zhihai1△; ZHANG Zhennan2; LI Yubin1; HAN Fei1
1 Department of Orthopedicst,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;
2Medical Department,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China.
关键词:
重力牵引;  脊髓性肌肉萎缩症;  脊柱侧凸
Keywords:
gravity traction;  spinal muscular atrophy;  scoliosis
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.230610
文献标志码:
B
摘要:
目的:分析Halo头环重力牵引在脊髓性肌肉萎缩症性脊柱侧凸患者中的临床疗效。方法:回顾性分析2019年8月至2022年3月,因脊髓性肌肉萎缩症性脊柱侧凸住院,行Halo头环重力牵引治疗的患者,对患者牵引前后坐高变化、牵引时长、胸闷改善情况、体重变化情况、是否进行2期矫形手术等相关指标分析总结。结果:共纳入16例脊髓性肌肉萎缩症性脊柱侧凸患者,牵引后坐高增加(6.44±1.79)cm,体重增加(3.38±1.63)kg,牵引时长为(8.56±4.29)个月,6例(37.5%)患者在牵引后行二期矫形手术,16例患者胸闷情况得到改善,视觉模拟量表(VAS)呼吸困难评分减低(2.50±1.21)分。性别、脊髓性肌肉萎缩症分型、年龄及牵引时长等因素对牵引后坐高影响差异无统计学意义(P=0.29,0.85,0.46,0.08)。结论:通过Halo头环重力牵引可减轻脊髓性肌肉萎缩症脊柱侧凸患者脊柱畸形,改善心肺功能,增加侧凸周围软组织柔韧度,减少脊柱畸形对脊髓的压迫,操作安全可靠,可为二期内固定矫形手术做好前期准备。
Abstract:
Objective:To investigate the clinical efficacy of Halo gravity traction in patients with spinal muscular atrophy(SMA)syndrome scoliosis.Methods:The patients who were hospitalized with Halo head ring gravity traction for SMA syndrome scoliosis from August 2019 to March 2022 were retrospectively analyzed.The changes of sitting height before and after traction,traction duration,improvement of chest tightness,weight change,whether to undergo stage-2 orthopaedic surgery and other related indicators were analyzed and summarized.Results:A total of 16 patients with SMA scoliosis were included.After traction,the sitting height increased by(6.44±1.79)cm,the weight increased by(3.38±1.63)kg,and the traction duration was(8.56±4.29)months.6 patients(37.5%)underwent two-stage orthopedic surgery after traction,the chest tightness was improved in all 16 patients,visual analogy scale(VAS)dyspnea score decreased by(2.50±1.21)points.Gender,SMA classification,age and traction duration on sitting height after traction had no significant difference(P=0.29,0.85,0.46,0.08).Conclusion:Halo head ring gravity traction can reduce spinal deformations in patients with SMA scoliosis,improve cardiopulmonary function,increase the flexibility of soft tissue around scoliosis,and reduce the compression of spinal cord by spinal deformations.The operation is safe and reliable,which can make preparations for two-stage internal fixation orthopaedic surgery.

参考文献/References:

[1] JABLONKA S,HENNLEIN L,SENDTNER M.Therapy development for spinal muscular atrophy:perspectives for muscular dystrophies and neurodegenerative disorders[J].Neurol Res Pract,2022,4(1):2.
[2] CHAYTOW H,FALLER K M E,HUANG Y T,et al.Spinal muscular atrophy:from approved therapies to future therapeutic targets for personalized medicine[J].Cell Rep Med,2021,2(7):100346.
[3] SUGARMAN E A,NAGAN N,ZHU H,et al.Pan-ethnic carrier screening and prenatal diagnosis for spinal muscular atrophy:clinical laboratory analysis of >72 400 specimens[J].Eur J Hum Genet,2012,20(1):27-32.
[4] MERCURI E,DARRAS B T,CHIRIBOGA C A,et al.Nusinersen versus sham control in later-onset spinal muscular atrophy[J].N Engl J Med,2018,378(7):625-635.
[5] BINDA O,JUILLARD F,DUCASSOU J N,et al.SMA-linked SMN mutants prevent phase separation properties and SMN interactions with FMRP family members[J].Life Sci Alliance,2022,6(1):e202201429
[6] LOMONTE P,BAKLOUTI F,BINDA O.The biochemistry of survival motor neuron protein is paving the way to novel therapies for spinal muscle atrophy[J].Biochemistry,2020,59(14):1391-1397.
[7] FELDKOTTER M,SCHWARZER V,WIRTH R,et al.Quantitative analyses of SMN1 and SMN2 based on real-time lightCycler PCR:fast and highly reliable carrier testing and prediction of severity of spinal muscular atrophy[J].Am J Hum Genet,2002,70(2):358-368.
[8] KOLB S J,KISSEL J T.Spinal muscular atrophy[J].Neurol Clin,2015,33(4):831-846.
[9] LUNN M R,WANG C H.Spinal muscular atrophy[J].Lancet,2008,371(9630):2120-2133.
[10] WANG J,HAN B,HAI Y,et al.How helpful is the halo-gravity traction in severe spinal deformity patients?A systematic review and meta-analysis[J].Eur Spine J,2021,30(11):3162-3171.
[11] REED L A,MIHAS A,BUTLER R,et al.Halo gravity traction for the correction of spinal deformities in the pediatric population:a systematic review and meta-analysis[J].World Neurosurg,2022,164e636-164e648.
[12] ARNOLD E S,FISCHBECK K H.Spinal muscular atrophy[J].Handb Clin Neurol,2018,148:591-601.
[13] AMICO A D,MERCURI E,TIZIANO F D,et al.Spinal muscular atrophy[J].Orphanet J Rare Dis,2011,6(2):71.
[14] MERCURI E,FINKEL R S,MUNTONI F,et al.Diagnosis and management of spinal muscular atrophy:part 1:recommendations for diagnosis,rehabilitation,orthopedic and nutritional care[J].Neuromuscul Disord,2018,28(2):103-115.
[15] FINKEL R S,MCDERMOTT M P,KAUFMANN P,et al.Observational study of spinal muscular atrophy type Ⅰ and implications for clinical trials[J].Neurology,2014,83(9):810-817.
[16] OSKOUI M,LEVY G,GARLAND C J,et al.The changing natural history of spinal muscular atrophy type 1[J].Neurology,2007,69(20):1931-1936.
[17] KOLB S J,COFFEY C S,YANKEY J W,et al.Natural history of infantile-onset spinal muscular atrophy[J].Ann Neurol,2017,82(6):883-891.
[18] ZERRES K,RUDNIK-SCHONEBORN S,FORREST E,et al.A collaborative study on the natural history of childhood and juvenile onset proximal spinal muscular atrophy(type Ⅱ and Ⅲ SMA):569 patients[J].J Neurol Sci,1997,146(1):67-72.
[19] LEFEBVRE S,BURGLEN L,REBOULLET S,et al.Identification and characterization of a spinal muscular atrophy-determining gene[J].Cell,1995,80(1):155-165.
[20] 吕亚丰,张艳君,程谟斌,等.脊肌萎缩症治疗研究进展[J].医学研究杂志,2019,48(2):176-180.
[21] SCHEFFER H,COBBEN J M,MATTHIJS G,et al.Best practice guidelines for molecular analysis in spinal muscular atrophy[J].Eur J Hum Genet,2001,9(7):484-491.
[22] PRIOR T W,NAGAN N,SUGARMAN E A,et al.Technical standards and guidelines for spinal muscular atrophy testing[J].Genet Med,2011,13(7):686-694.
[23] 程剑洋,王策,姜横,等.术前Halo重力牵引对重度僵硬型脊柱侧凸患者肺功能和营养状况的作用[J].脊柱外科杂志,2017,15(1):1-6.
[24] 李唐波,林涛,孟怡辰,等.术前Halo重力牵引辅助治疗青少年重度脊柱侧凸畸形的临床疗效[J].中国临床医学,2017,24(4):510-513.
[25] 刘盾,李洋,史本龙,等.Halo重力牵引在Ⅰ型神经纤维瘤病伴严重脊柱侧后凸畸形患者中的应用研究[J].中华外科杂志,2019,57(2):119-123.
[26] BLONDA A,BARCINA LACOSTA T,TOUMI M,et al.Assessing the value of nusinersen for spinal muscular atrophy:a comparative analysis of reimbursement submission and appraisal in european countries[J].Front Pharmacol,2021,12:12750742.
[27] GIDARO T,SERVAIS L.Nusinersen treatment of spinal muscular atrophy:current knowledge and existing gaps[J].Dev Med Child Neurol,2019,61(1):19-24.
[28] CARSON V J,YOUNG M,BRIGATTI K W,et al.Nusinersen by subcutaneous intrathecal catheter for symptomatic spinal muscular atrophy patients with complex spine anatomy[J].Muscle Nerve,2022,65(1):51-59.
[29] WIJNGAARDE C A,BRINK R C,DE KORT F A S,et al.Natural course of scoliosis and lifetime risk of scoliosis surgery in spinal muscular atrophy[J].Neurology,2019,93(2):e149-e158.

备注/Memo

备注/Memo:
△通信作者 E-mail:ZZH@sina.com
更新日期/Last Update: 2023-06-10