臨床整形外科54巻1号

2019年01月発行

誌上シンポジウム 小児の脊柱変形と脊椎疾患—診断・治療の急所

先天性脊柱変形とその関連症候群—胸郭不全症候群，VATER症候群など

著者： 川上紀明¹

所属機関： ¹国家公務員共済組合連合会名城病院整形外科・脊椎脊髄センター

ページ範囲：P.25 - P.36

はじめに

　先天性に生じる椎骨の形態異常は，側弯や後弯など何らかの症状が生じない限り見逃されることがあり，成人後に偶然X線写真で指摘されることも少なくない．このように無症候性に経過したものは，もちろん臨床上治療対象とはならない．その一方で，幼・小児期から側弯や後弯などが悪化し，いろいろな症状を引き起こす病態もある．しかも，幼・小児期から成長に伴って悪化する変形は，早期発見，早期治療が必要であり，手遅れになると日常生活動作(ADL)のみならず，生命予後にも影響を与える場合がある．本稿では，椎骨の先天性奇形により生じ，整形外科医師にとってその特徴を頭に入れておかなければならない疾患群などについて診断と治療法のピットフォールについて述べる．

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