预测支具治疗女性青少年特发性脊柱侧凸畸形加重的相关参数分析  

Analysis of curve progression and its related factors in female patients with adolescent idiopathic scoliosis treated with a brace

作　　者：张勇[1] 杨毅军[1] 党晓谦[2] 赵黎[3] 任娟[4] 

机构地区：[1]西安市儿童医院骨科,西安710003 [2]西安交通大学医学院第二附属医院骨科 [3]上海交通大学医学院附属新华医院儿童骨科 [4]西安交通大学医学院第一附属医院

出　　处：《山西医科大学学报》2014年第5期410-413,共4页Journal of Shanxi Medical University

摘　　要：目的探讨预测支具治疗女性青少年特发性脊柱侧凸畸形加重的相关参数,寻找准确预测畸形加重的方法。方法回顾性分析89例女性青少年特发性脊柱侧凸患者的临床资料,随访期间连续测量患者的年龄、初始Cobb角、侧凸类型、女性患者初潮与否、坐高、站高、Risser征、侧凸方式、顶椎旋转度、脊柱长度增长速度10项相关参数,分析初诊和末次随访时患者的畸形变化情况。并通过logistic回归分析筛选与AIS进展相关性较强的参数。结果 89例患者初诊时年龄10-16岁,平均13.6岁,平均随访时间为24.8月。末次随访时,21例(23.60%)患者畸形加重。logistic回归分析发现Risser指数2以下、初诊时侧凸角度大于35°,顶椎旋转度大于Ⅲ度,脊柱长度增长速度大于20 mm/年是导致侧凸进展的相关因素。结论脊柱长度增长速率、Risser指数、初诊时侧凸角度、顶椎旋转度是女性青少年特发性脊柱侧凸畸形加重的重要预测参数。Objective To explore the related factors in predicting the progression of the scoliosis in female patients with adolescent idiopathic scoliosis treated with a brace. Methods The clinical data of 89 female AIS patients were reviewed. A series of parameters were consecutively measured and documented during the period of follow-up. Curve behavior at the first visit and the final follow- up was analyzed. Several parameters which may contribute to the progression of curve were selected by a logistic regression analysis. Results Mean age of patients at the first visit was 13. 6（ 10- 16） years. The patients were followed for 12- 72 months（ mean 24. 8 months）. At the last visit,21 patients（23. 60%） were found curve progression more than 5 degrees. The logistic regression analysis showed that Risser sign less than two,the magnitude of the major curve at the primary prebrace greater than 35°,apical vertebral rotation beyond grade Ⅲ,and the spinal length increasing larger than 20 mm in one year were risk factors to predict the progression of more than 5°. Conclusion The results suggest that Risser sign,the magnitude of the major curve at the primary prebrace,the apical vertebral rotation,and the spinal length increasing velocity may be important factors to predict progression in the female patients with AIS. Risser sign can not predict the progression of scoliosis accurately unless combined with other related parameters.

关 键 词：脊柱侧凸 青少年 支具 疾病进展 

分 类 号：R681.5[医药卫生—骨科学]