3种摄片方法预测青少年特发性脊柱侧凸矫形结果的对比研究  

Comparative analysis of three radiographic way in prediction of correction of adolescent idiopathic scoliosis

作　　者：陈庆贺[1] 周跃[1] 高吉昌[2] 张承敏[2] 王建[1] 王仑[2] 卢淼[2] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400037 [2]解放军第211医院骨科,哈尔滨150080

出　　处：《中国矫形外科杂志》2007年第23期1815-1817,共3页Orthopedic Journal of China

摘　　要：[目的]评估术前站立位、支点弯曲位、重力悬吊牵引位和仰卧侧屈位X线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。[方法]对63例青少年特发性脊柱侧凸患者的79个结构性侧凸摄术前站立位、支点弯曲位、重力悬吊牵引位和仰卧侧屈位X线片,将其与术后的站立位X线片比较,测量全部Cobb’s角后进行统计学处理,并评估其价值。[结果]结构性胸凸组与结构性腰凸组重力悬吊牵引位片Cobb’s角分别是40°和21°,仰卧侧屈位片Cobb’s角分别是41°和23°,支点弯曲位片Cobb’s角分别是35°和19°,术后站立位片Cobb’s角分别是36°和18°;重度组（≥60°）与中度组（〈60°）重力悬吊牵引位片Cobb’s角分别是52°和23°,仰卧侧屈位片Cobb’s角分别是53°和24°,支点弯曲位片Cobb’s角分别是47°和20°,术后站立位片Cobb’s角分别是44°和19°;僵硬组与柔软组重力悬吊牵引位片Cobb’s角分别是51°和22°,仰卧侧屈位片Cobb’s角分别是52°和22°,支点弯曲位片Cobb’s角分别是48°和18°,术后站立位片Cobb’s角分别是45°和17°;前路手术组与后路手术组重力悬吊牵引位片Cobb’s角分别是47°和15°,仰卧侧屈位片Cobb’s角分别是49°和16°,支点弯曲位片Cobb’s角分别是43°和11,°术后站立位片Cobb’s角分别是42°和10°,以上角度均为平均值。平均随访时间是1.5年（11-37个月）。[结论]支点弯曲位X线片比重力悬吊牵引位和仰卧侧屈位X线片能更准确地预测术后矫正效果,并能为选择前路或后路术式,以及融合节段提供依据。[Objective]To evaluate the role of three radiographic ways in patients undergoing spinal three-dimensional correction and fusion for adolescent idiopathic scoliosis.[Method]Sixty-three cases of adolescent idiopathic scoliosis（AIS）with 79 structural curves were studied.Preoperative X-ray of standing,gravity-suspendig traction,supine bending and fulcrum bending were compared with postoperative standing X-ray one week after surgery,Cobbs angle of all X-ray were measured and statistical significance was evaluated.[Result]In structural thoracic group and lumbar group the mean Cobbs angle were 40°and 21°in gravity-suspendig traction X-ray,41°and 23°in supine bending X-ray,35°and 19°in fulcrum bending X-ray,36°and 18°in postoperative standing X-ray respectively.In severe group and moderate group the mean Cobbs angle were 52°and 23°in gravity-suspendig traction X-ray,53°and 24°in supine bending X-ray,47°and 20°in fulcrum bending X-ray,44°and 19°in postoperative standing X-ray respectively.In rigid group and flexible group the mean Cobbs angle were 51°and 22°in gravity-suspendig traction X-ray,52°and 22°in supine bending X-ray,48°and 18°in fulcrum bending X-ray,45°and 17°in postoperative standing X-ray respectively.In anterior approach group and posterior approach group the mean Cobbs angle were 47°and 15°in gravity-suspendig traction X-ray,49°and 16°in supine bending X-ray,43°and 11°in fulcrum bending X-ray,42°and 10°in postoperative standing X-ray respectively.All above Cobbs angle were mean numerical value,the mean follow-up period was 1.5 years（range：1~3 years）.[Conclusion]The fulcrum bending X-ray are more predicting of correctability of AIS patients than the gravity-suspendig traction and supine bending X-ray.It can provide reference for chosing anterior or posterior approach and chosing fusion levels.

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：R682[医药卫生—骨科学]