影像学评估生长棒技术治疗先天性脊柱侧凸对胸廓发育的影响

发布时间：2018-06-14 14:52

本文选题：先天性脊柱侧凸 + 生长棒技术　；参考：《中国矫形外科杂志》2017年21期

【摘要】：[目的]通过影像学测量脊柱高度和胸廓容积变化,评估生长棒技术治疗先天性脊柱侧凸对胸廓发育的影响。[方法]分析2010年7月~2016年7月本院23例应用生长棒技术治疗的先天性脊柱侧凸患儿的完整资料,测量术前、初次及各次撑开术后和末次随访时脊柱全长正侧位X线片脊柱和胸廓发育相关参数指标,包括主胸弯Cobb角、T_1~T_(12)高度、胸椎后凸角度、胸廓前后径和矢状纵径、胸廓最大宽度、坎贝尔空间供肺比值,并进行统计学分析。[结果]初次及各次撑开术后和末次随访时,主胸弯Cobb角、TK、T_1~T_(12)高度、胸廓最大宽度、胸廓前后径和矢状纵径以及SAL均较术前差异有统计学意义(P0.05);术前到末次随访主胸弯Cobb角变化值与T_1~T_(12)高度(r=0.584,P0.05)、胸廓矢状高度(r=.0594,P0.05)及SAL的变化值间(r=0.693,P0.05)呈正相关;随撑开次数增加,各项胸廓发育参数变化曲线先显著增加后逐渐趋于平缓。[结论]利用生长棒技术治疗先天性脊柱侧凸,不仅能够矫正脊柱畸形、保留脊柱生长潜能,还可以调整左右胸廓的高度差和不对称性,增加胸廓容积容量,但随着撑开次数增加,这种效应逐渐趋于减弱。
[Abstract]:[objective] to evaluate the effect of growth rod technique on thoracic development of congenital scoliosis by imaging measurement of spine height and thoracic volume. [methods] the complete data of 23 children with congenital scoliosis treated by growth rod technique from July 2010 to July 2016 were analyzed. The parameters related to the development of spine and thorax in full-length X-ray radiographs of the spine after the first and the last follow-up, including the height of the main thoracic curvature Cobb angle T _ 1 and T _ (12), the thoracic kyphosis angle, the anterior and posterior thoracic diameter and the sagittal longitudinal diameter, the maximum width of the chest, were analyzed. Campbell's space donor lung ratio was analyzed statistically. [results] at the first and the last follow-up, the Cobb angle of the main thoracic curvature was TKT _ 1 / T _ T _ (12) height and the maximum chest width. There were significant differences in the anterior and posterior diameter of chest, sagittal longitudinal diameter and sal, and there was a positive correlation between the Cobb angle of the main thoracic curvature and the height of T _ (1) T _ (12), sagittal height of chest, and the change of sagittal height (r ~ (0.693) P _ (0.05), and the change of Cobb angle was positively correlated with T _ 1 / T _ T _ (12) (P _ (0.05), r = 0.594P _ (0.05) and sagittal height (r = 0.693p _ (0.05). The variation curve of thoracic development parameters increased significantly and then tended to be flat gradually. [conclusion] using growth rod technique to treat congenital scoliosis can not only correct the deformity of spine, preserve the potential of spinal growth, but also adjust the height difference and asymmetry of left and right chest, increase the volume of chest. However, with the increase of opening times, this effect tends to weaken gradually.
【作者单位】：中南大学湘雅二医院脊柱外科;
【基金】：国家自然科学基金青年项目(编号:81601858)
【分类号】：R726.8

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