特发性脊柱侧凸术后躯干失平衡及其原因分析  

Coronal trunk imbalance after posterior idiopathic scoliosis correction

作　　者：李明[1] 倪春鸿[1] 侯铁胜[1] 赵新刚[1] 朱晓东[1] 陈语[1] 白玉树[1] 

机构地区：[1]上海长海医院骨科,上海200433

出　　处：《颈腰痛杂志》2003年第6期327-330,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：国家自然科学基金 (30 2 71 4 4 0 );上海市科技启明星跟踪计划基金 (2 0 0 2 QB1 4 0 3)资助

摘　　要：目的　对 6 2例行后路矫形的青少年特发性脊柱侧凸术前及术后躯干平衡情况进行回顾性观察 ,探讨术后躯干失平衡的可能原因。方法　回顾性分析 1997年至 2 0 0 1年连续收治施行三维矫形手术的 6 2例特发性脊柱侧凸患者。平均年龄 14 .4岁 ,术后平均随访时间 35月 (12月～5 7月 )。进行 CD、TSRH及 CD Horizon系统的矫形内固定脊柱融合术 ,观察各型脊柱侧凸术后的躯干平衡情况。结果　有 5 3例 (85 .5 % )患者术前 X线片检查提示冠状面有 1cm以上的失平衡。失平衡以向左侧多见 (占 95 % ) ,范围在 - 3.4 cm到 +4.3cm之间 ,平均为 +3.1cm。 4 8%的患者术后X线片检查仍有失平衡存在 ,但平均偏离距离为 +1.2 cm ,较术前有显著改善。结论　三维矫形术后躯干失代偿的发生可能主要与融合节段尤其是下方融合节段选择不当有关。骨骼成熟度较低的患者 。Objectives To explore the possible reason for coronal trunk imbalance after posterior idiopathic scoliosis correction.Methods From 1997 through 2000, 62 consecutive patients (45 females, 17 males) with an average age of 14.4 underwent 3-dimentional scoliosis correction. 60 patients were observed for an average of 35 months (range, 12-57 months). The correction and coronal trunk imbalance were observed.Results The average Cobb's angle was 57°before surgery, 18° after surgery (68% correction), and 21° at latest follow-up. 85.5%(53/62)demonstrated preoperative trunk imbalance. Most of the trunk shift to left (95%). The average amount of deviation from the midbody of T1 to CSVL (cervical sacral vertebral line) preoperatively is +3.1cm and the average deviation postoperatively is +1.2cm. The imbalance was significantly improved after surgery.Conclusions Correction magnitude, fusion level selection and surgery strategies may influence the trunk balance of scoliosis patients.

关 键 词：特发性脊柱侧凸 术后并发症 躯干失平衡 三维矫形手术 脊柱融合术 

分 类 号：R682.13[医药卫生—骨科学]