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首页> 外文期刊>Spine >Progression of idiopathic thoracolumbar scoliosis after breast reconstruction with a latissimus dorsi flap: a case report.
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Progression of idiopathic thoracolumbar scoliosis after breast reconstruction with a latissimus dorsi flap: a case report.

机译：乳腺背阔肌皮瓣重建乳房后特发性胸腰段脊柱侧弯的进展：一例报告。

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STUDY DESIGN: A report of a patient in whom progressive symptomatic thoracolumbar scoliosis developed after breast reconstruction with a latissimus dorsi myocutaneous flap. OBJECTIVES: To present the first reported case of progressive symptomatic scoliosis after breast reconstruction with a latissimus dorsi myocutaneous flap and to suggest that latissimus flap harvest may be contraindicated in patients with preexisting scoliosis. SUMMARY OF BACKGROUND DATA: Latissimus dorsi myocutaneous flap harvest incorporated into several surgical operations including breast reconstruction has been presented as a relatively benign procedure without significant biomechanical consequence. Nevertheless, various anatomic and animal studies have suggested an important role for balanced latissimus function in terms of proper spinal alignment. Long-term follow-up evaluation of patients after latissimus flap harvest is insufficient and fails to address the specific issue of spinal deformity. METHODS: Postoperative radiographs demonstrated significant progression of the patient's thoracolumbar scoliosis as compared with radiographs taken before her latissimus harvest. Curve progression accompanied by development of severe and disabling back pain were considered indications for surgical curve correction and stabilization. RESULTS: At the time of 1-year follow-up assessment after posterolateral spinal fusion and instrumentation, the patient had experienced complete relief from her back pain and satisfactory spinal fusion. CONCLUSIONS: Although a cause and effect relation cannot be established, this case study suggests that latissimus harvest may have a destabilizing effect on the thoracolumbar spine in the long term, especially in patients with preexisting scoliosis. Alternative procedures should be considered in these patients.
机译：研究设计：一位患者的报告，该患者在乳房重建后使用背阔肌肌皮瓣发生进行性症状性胸腰椎侧弯。目的：提出第一例报告的乳房再造后背阔肌肌皮瓣的进行性症状性脊柱侧凸的病例，并建议在已有的脊柱侧弯患者中禁忌阔蒂皮瓣的收获。背景数据概述：已将背阔肌肌皮瓣收获物纳入包括乳房再造在内的几种外科手术中，是一种相对良性的手术，没有明显的生物力学后果。然而，各种解剖学和动物学研究表明，在适当的脊柱排列方面，平衡的阔肌功能具有重要作用。阔肌皮瓣收获后对患者的长期随访评估不足，无法解决脊柱畸形的特定问题。方法：术后X线片显示患者的胸腰段脊柱侧弯进展明显，较之阔叶松收前的X线片更显着。曲线进展伴有严重的和致残的背痛发展被认为是手术曲线校正和稳定的指征。结果：在后外侧脊柱融合术和器械治疗后的1年随访评估中，该患者的背痛和令人满意的脊柱融合术已完全缓解。结论：尽管无法建立因果关系，但本案例研究表明，长期以来，阔叶收成可能会对胸腰椎造成不稳定的影响，尤其是对于已有脊柱侧弯的患者。这些患者应考虑采用其他程序。

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