不同摄片方法预测青少年特发性脊柱侧凸三维矫形融合术效果的比较(英文)  

Comparison of different radiographic films in predicting the three-dimensional correction and fusion of adolescent idiopathic scoliosis

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

机构地区：[1]解放军第二一一医院骨科,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31期6302-6304,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:站立侧屈、仰卧侧屈、侧方按压、俯卧推压和牵引下摄X射线片对预测哈氏法和卢氏法手术的矫正效果确实有效,但均不能更好地预测目前应用的三维椎弓根钉棒矫形系统的矫正效果。目的:评估术前支点弯曲位、重力悬吊牵引位和仰卧侧屈位X射线平片在预测青少年特发性脊柱侧凸三维矫形融合术效果的价值。设计:对比观察。单位:解放军第二一一医院骨科(全军骨科中心)。对象:选择2003-01/2005-12解放军第二一一医院骨科就诊的63例青少年特发性脊柱侧凸患者,男18例,女45例,年龄10￣21岁。均经临床检查及X射线平片诊断为青少年特发性脊柱侧凸;Cobb角≥40°;患者均对检测项目知情同意。方法:术前对63例青少年特发性脊柱侧凸患者的79个结构性侧凸摄站立位全脊柱正侧位片、支点弯曲位片、重力悬吊牵引位片和仰卧侧屈位片,术后1周时摄站立位全脊柱正侧位片。主要观察指标:青少年特发性脊柱侧凸术前支点弯曲位Cobb角与术后实际Cobb角。结果:患者63例均进入结果分析。术前支点弯曲位Cobb角与术后站立位比较,差异无显著性意义(P>0.05);而术前重力悬吊牵引位和仰卧侧屈位Cobb角与术后站立位比较,差异有显著性意义(P<0.05)。结论:支点弯曲位X射线平片比重力悬吊牵引位和仰卧侧屈位X射线平片能更准确地预测术后矫正效果,而重力悬吊牵引位与仰卧侧屈位摄片的预测结果相似。BACKGROUND：Standing bending, supine bending, lateral pressing, pronation compression films and traction radiography are indeed effective to predict the correction outcome of surgeries by Harrington＇s method and Lugue＇s method,however, they are discontented for the correction of three-dimensional pedicle screw of vertebral arch. OBJECTIVE： To evaluate the role of preoperative X-ray films of gravity-suspending traction, supine bending and fulcrum bending in patients undergoing spinal three-dimensional correction and fusion for adolescent idiopathic scoliosis （AIS）. DESIGN： Contrast observation. SETTING： Department of Orthopaedics, the 211 Hospital of Chinese PLA （Military Orthopaedics Center）. PARTICIPANTS： From January 2003 to December 2005, 63 cases aged 10-21 years were recruited from Department of Orthopaedics in the 211 Hospital of Chinese PLA, including 18 males and 45 females. They were diagnosed as AIS by clinical examinations and X-ray film, with Cobb angle≥40°. Informed consents were obtained from all the subjects. METHODS： All of the 63 AIS cases with 79 structural curves were studied by preoperative X-ray films of standing,gravity-suspending traction, supine bending and fulcrum bending, which were compared with standing X-ray films one week postoperatively. MAIN OUTCOME MEASURES： Cobb angles of preoperative fulcrum bending film and postoperative standing film. RESULTS： All of the 63 cases were involved in the result analysis. There was no significant difference in the Cobb angle between preoperative fulcrum bending X-ray film and postoperative standing X-ray film （P 〉 0.05）. Gravity-suspending traction and supine bending films were significantly different from postoperative standing film （P 〈 0.05）. CONCLUSION： The fulcrum bending X-ray films are superior to gravity-suspending traction and supine bending films in predicting the postoperative correction of AIS patients.

关 键 词：青少年特发性脊柱侧凸 影像学 柔韧性 脊柱融合 

分 类 号：R318[医药卫生—生物医学工程]