نویسندگان

1 دانشگاه علوم پزشکی ایران

2 بیمارستان رسول اکرم

3 دانشگاه ارتز و پروتز

چکیده

مقدمه: عمل جراحی در سطح صحیح، یکی از مهمترین نگرانی‌ها در درمان بیماران اسکولیوز ایدیوپاتیک نوجوانان (AIS) است. تغییر در تعداد مهره‌ها می‌تواند به طور بالقوه منجر به انجام جراحی اشتباه شود. این امکان وجود دارد که بروز و نوع این تغییرات تحت تأثیر عوامل مختلفی از قبیل نژاد باشد. در مطالعه گذشته نگر حاضر، شیوع این تغییرات در بیماران مبتلا به AIS ایرانی بررسی شده است.
مواد و روش‌ها: از سال 2012 تا 2017، جراحی فیوژن ستون فقرات برای درمان AIS در 125 بیمار انجام شد. مهره‌های پشتی و کمری تحت رادیوگرافی‌ خلفی بعد از عمل قرار گرفتند. اولین مهره پشتی، مهره متصل به اولین جفت دنده در نظر گرفته شد. شمارش از بالا به پایین انجام شد. مهره های ناحیه کمری دقیقاً از زیر آخرین مهره که یک جفت دنده به آن متصل بود شروع می شد.
یافته‌ها: در 18 بیمار (14.4٪) شمارش غیر طبیعی مهره مشاهده شد. شیوع تعداد غیر طبیعی مهره های کمری نسبت به مهره‌های پشتی بیشتر بود (10.4٪ در مقابل 4٪). در 5 بیمار (4٪) تعداد 11مهره پشتی مشاهده شد. در 11 بیمار (8/8٪) 4 مهره کمری مشاهده شد. 2 بیمار، 6 مهره کمری (1.6٪) داشتند. هیچ بیماری با تعداد غیر طبیعی مهره‌های پشتی و کمری همزمان وجود نداشت.
نتیجه‌گیری: مطالعه حاضر نشان داد که در بیماران مبتلا به AIS در ایران تعداد غیر طبیعی مهره‌های پشتی و کمری نسبتاً بالا است. لازم است که قبل از عمل مهره‌ها را بر اساس یک پروتکل سازمان یافته شمارش کرده تا از جراحی اشتباه در بیماران AIS جلوگیری شود.

کلیدواژه‌ها

عنوان مقاله [English]

Variations in the number of vertebrae among Iranian patients with adolescent idiopathic scoliosis

نویسندگان [English]

  • H Ghandhari 1
  • M Rashidi 1
  • S Sabbaghan 1
  • S M Mahdavi 2
  • E Mirzamohammadi 1
  • A Azizi 1
  • F Safdari 3

چکیده [English]

Introduction: Correct-level surgery is one of the most important concerns in the treatment of patients with adolescent idiopathic scoliosis (AIS). Variations in vertebral number can potentially result in wrong-level surgery. It is possible that the incidence and type of these variations be affected by different factors such as ethnicity. In the current retrospective study, the prevalence of these variations in Iranian AIS patients was investigated.  
Methods: Between 2012 to 2017, spinal fusion was performed for the treatment of AIS in 125 patients. The thoracic and lumbar vertebrae were enumerated on posteroanterior radiographs. The first thoracic vertebra was the one attached to the first pair of ribs. Enumeration was continued in a caudal direction. The lumbar level initiated just below the last vertebra with a pair of associated ribs.
Results: Abnormal vertebral enumeration was found in 18 patients (14.4%). The prevalence of abnormal lumbar enumeration was higher than thoracic vertebrae (10.4% versus 4%). Eleven thoracic vertebrae were found in 5 patients (4%). Four lumbar vertebrae were found in eleven patients (8.8%). There were two patients with six lumbar vertebrae (1.6%). There was no patient with abnormal enumeration of both thoracic and lumbar vertebrae.
Conclusion: The current study showed a relatively high rate of atypical number of thoracic and lumbar vertebrae in Iranian AIS patients. It is necessary to enumerate the vertebrae on the basis of an organized protocol preoperatively to prevent wrong-level surgery in AIS patients.

کلیدواژه‌ها [English]

  • Keywords: Scoliosis
  • Vertebra
  • Adolescent
  • Spinal Fusion
  1. H Ghandhari: Study concept and design, Acquisition of data, Study supervision
  2. M Rashidi: Acquisition of data, Drafting of the manuscript, Administrative, technical, and material support,
  3. S Sabbaghan: Acquisition of data, Interpretation of data, Administrative technicaland material support
  4. SM Mahdavi: Study concept and design, Acquisition of data, Drafting of the manuscript,
  5. E Mirzamohammadi: Critical revision of the manuscript for important intellectual content, Statistical analysis, Administrative, technical, and material support
  6. A Azizi: Critical revision of the manuscript for important intellectual content, Statistical analysis, Study supervision
  7. F Safdari: Interpretation of data, Drafting of the manuscript, Interpretation of data
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