新型支点侧屈位X线片在脊柱侧凸中的应用研究  

The Application Research of New Fulrum Bending X-ray Films in Scoliosis

作　　者：杨依林[1] 王飞[1] 栗景峰[1] 魏显招[1] 陈自强[1] 朱晓东[1] 李明[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海200433

出　　处：《实用骨科杂志》2017年第3期208-211,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨新型支点侧屈位X线片应用于青少年特发性脊柱侧凸选择性胸弯融合中的临床疗效。方法采用自行设计的新型支点侧屈位装置,对我院2013年6月至2014年4月住院的23例青少年特发性脊柱侧凸患者行术前融合节段的选择,其中女性18例,男性5例,平均年龄14.8岁(10.0~19.0岁),13例为Lenke 1AN型;4例为Lenke 1BN型;1例为Lenke 1A-;5例为Lenke 1CN型。影像学评估包括术前站立后前位X线片、新型支点侧屈位X线片以及术后1周、末次随访的站立后前位X线片。测量患者Cobb角,计算该方法比传统方法节省的融合节段。结果术前站立后前位X线片Cobb角平均为(43.7±6.0)°,新型最大支点侧屈位X线片Cobb角平均为(9.2±4.8)°,术后1周站立后前位X线片Cobb角平均为(9.6±3.7)°,末次随访站立后前位X线片Cobb角平均为(10.8±3.7)°。新型最大支点侧屈位X线片平均Cobb角与术后1周站立后前位X线片Cobb角相比差异无统计学意义(t=0.7;P=0.483);术后1周站立后前位X线片平均Cobb角与末次随访的站立后前位X线片平均Cobb角相比差异无统计学意义(t=5.5;P=0.001)。23例AIS患者中17例(74%)患者比传统的Harrington方法节省了至少一个以上融合节段。结论新型支点侧屈位X线片能够安全有效的评估青少年特发性脊柱侧凸融合节段的选择。与传统方法相比较,在青少年特发性脊柱侧凸矫形中应用新型支点侧屈位X线片能够节省融合节段,更多的保留脊柱活动度。Objective to explore the effectof new fulcrum bending film technique on fusion strategy of adolescent id-iopathic scoliosis.Methods Based on new-designed fulcrum bending film technique,the fusion level of 23 AIS patients, which enrolled from June 2013 to April 2014,was identified before scoliosis operation.The study cohort had a mean age of 14.8 years（10~19 years）of which 18 were female and 5 male.AS regarded to Lenke classification,there 13 type 1AN,4 type 1BN,1 type 1A- and 5 type 1CN.Besides radiological measurements were taken from Long-cassette standing anteroposterior film preoperative,immediate postoperative（1 week）and latest follow-up,fulcrum bending film was measured preoperatively.According to magnitude of Cobb angle,reservation of fusion segments could be calculated. Results there was no statistically different between average Cobb angle of new fulcrum bending film preoperatively and that of anteroposterior standing film immediate postoperative（t=0.7,P=0.483）;and no significant changes appeared in the period from immediate postoperative to latest visit （t=5.5,P=0.001）.17 of 23 population reserved one more motion segments compared with traditional Harrington technique.Conclusion New fulcrum bending film technique could safely evaluated the selection of fusion level in AIS patients.In contrast with traditional method,it could reserve more fusion vertebrae,saving more motion segments of spine.

关 键 词：脊柱侧凸 支点侧屈位 融合节段 

分 类 号：R682.13[医药卫生—骨科学]