热塑矫形支具治疗青少年特发性脊柱侧凸:疗效及材料和宿主反应随访  

Thermosetting plastic brace treatment for adolescent idiopathic scoliosis: A follow-up of curative effect and host response

作　　者：陈庆贺[1] 卢淼[1] 高吉昌[1] 张承敏[1] 王正雷[1] 王仑[1] 张文进[1] 

机构地区：[1]解放军第二一一医院全军骨科中心,黑龙江省哈尔滨市150080

出　　处：《中国组织工程研究与临床康复》2007年第26期5237-5239,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:回顾性分析支具矫正的青少年特发性脊柱侧凸适应证及临床效果。方法:对2003-01/2005-12在解放军第211医院骨科收治的106例未做过治疗的生长发育期青少年特发性脊柱侧凸患者,给予热塑矫形支具治疗。男21例,女85例;年龄8～19岁,平均(13.1±3.6)岁。单胸凸49例,双胸凸8例,胸和腰双凸37例,胸腰段或腰凸12例。原发Cobb角20°～42°,平均(±6.4)°。Risser征0度51例,Ⅰ度33例,Ⅱ度19例,Ⅲ度3例。支点29.5弯曲位时的矫正率≥50%的柔软性侧凸57例,<50%的僵硬性侧凸49例。每3～6个月复查1次,摄站立位全脊柱正侧位X射线片。结果:①全部病例随访24～72个月,平均36个月,79例(74.5%)治疗有效(原发性侧凸Cobb角增加≤5°,或是胸腰双主弯中继发侧凸超过原发侧凸≤5°),27例(25.5%)出现脊柱侧凸进展,治疗无效。②柔软性侧凸57例,支具矫正有效是48例;僵硬性侧凸49例,有效是37例,柔软性侧凸的矫正效果优于僵硬性侧凸。③脊柱侧凸Cobb角在20°°者63例,有效是54例,～2930～40°者43例,有效是25例,Cobb角20°°组的矫正效果优于Cobb角30°°组。③未出现特殊的材料和宿主的明显～29～40不良反应和负性事件,但腰、髋部骨密度明显下降。结论:①热塑矫形支具矫正青少年特发性脊柱侧凸能够取得良好疗效。②骨骼正处于生长发育期者,侧凸柔软性好者,Cobb角较小者,矫正效果好。③支点弯曲位时的矫正率可以预测支具矫正效果。④随访中发现应用支具后患者腰、髋部骨密度明显下降。AIM： To retrospectively review the indications and clinical outcomes of brace correction for adolescent idiopathic scoliosis （AIS）. METHODS： Between January 2003 to December 2005, 106 immatured skeleton patients suffered from AIS with no history of prior treatment were selected from Department of Orthopedics in the 211 Hospital of Chinese PLA. They were treated with thermosetting plastic brace, including 21 males and 85 females, aged 8-19 years with a mean age of （13.1±3.6） years. There were 49 cases having single thoracic curve, 8 cases double thoracic curve, 37 cases thoracic and lumbar double major curve, and 12 cases either single thoraco-lumbar or single lumbar curve. The mean primary curve was （29.5±6.4）° （ranging 20°-42°）. Risser sign was 0° in 51 cases, Ⅰ° in 33 cases, Ⅱ° in 19 cases, and Ⅲ° in 3 cases. Flexible scoliosis in 57 cases was defined as correction rate at fulcrum bending 〉t 50%, while rigid scoliosis in 49 cases 〈 50%. The standing antero-posterior projection X-ray films were obtained at intervals of 3 to 6 months. RESULTS： All the patients were followed up for 24-72 months （mean 36 months）, 79 cases （74.5%） with the brace showed a good effectiveness （Cobb＇s angle primary scoliosis increased ≤5°, or secondary scoliosis exceeded ≤5° compared with primary scoliosis of thoracic and lumbar double major curve）, 27 cases （25.5%） were judged as curve progression, indicating the treatment failure.①The brace correction was effective in 48 cases of 57 flexible scoliosis and 37 cases of 49 rigid scoliosis. The correction outcomes of flexible scoliosis were superior to that of rigid scoliosis.②The lower the Cobb＇s angle, the higher the brace correction rate （54163, 25/43）. The brace correcting effectiveness in patients with a Cobb＇s angle from 20° to 29° was higher than that with a Cobb＇s angle from 30° to 40°. ③No obvious adverse effect or negative event between materials and host appeared, but the bone density of waist

关 键 词：青少年特发性脊柱侧凸 支具 治疗 

分 类 号：R496[医药卫生—康复医学]