AIS患者主侧凸及总体侧凸向量对手术前后躯干冠状面平衡的影响

发布时间：2018-02-25 21:48

本文关键词： 青少年特发性脊柱侧凸椎弓根钉-棒系统躯干冠状面平衡侧凸向量　出处：《福建医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：【目的】探究青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者主侧凸向量、总体侧凸向量对手术前后躯干冠状面平衡(coronal trunk balance,CTB)的影响。【方法】回顾性分析2011~2013年福建省立医院骨科采用一期单纯后路椎弓根钉-棒系统矫形治疗的22例AIS患者。纳入研究的患者术前、术后均拍摄站立位的脊柱全长正侧位X光片,术前拍摄仰卧位左右bending位X光片。引入物理中表示大小和方向的向量概念,对术前和术后末次随访时冠状面C7铅垂线(C7 plumb line,C7PL)相对于骶骨中垂线(center sacral vertical line,CSVL)的偏移向量、主侧凸向量、所有侧凸(各主、次侧凸)向量之和等参数进统计分析。【结果】22例AIS患者,男5例,女17例,术时平均年龄14.3岁(12.2~18.0岁),平均随访12个月(6~24个月)。手术前后,主侧凸cobb角、所有侧凸cobb角之和、C7PL-CSVL大小的差异有统计学意义(P0.05,t值分别为9.37、2.21、8.56)。术前C7PL-CSVL向量与术前主侧凸向量有统计学相关性(r=0.447,P0.05),术前C7PL-CSVL向量与术前所有侧凸向量之和有统计学相关性(r=0.510,P0.01)。手术前后,C7PL-CSVL大小与主侧凸cobb角大小、C7PL-CSVL大小与所有侧凸(各主次侧凸)cobb角大小之和无统计学相关性(P0.05)。主侧凸校正量与C7PL-CSVL变化量、主侧凸矫正率与C7PL-CSVL变化率无统计学相关性(P0.05)。【结论】干预(支具、手术)AIS患者可能出现的躯干冠状面失平衡的重点应该是防止躯干整体向主侧凸和总体侧凸的凸出方向偏移。AIS患者侧凸Cobb角与冠状面C7PL-CSVL大小无直接关系,主侧凸的矫正与躯干冠状面偏移的矫正无直接关系。
[Abstract]:[objective] to investigate the principal scoliosis vector of adolescent idiopathic scoliosis in Adolescent idiopathic scoliosisa. Effect of total scoliosis vector on coronal trunk before and after operation. [methods] A retrospective analysis was made on 22 cases of AIS treated by one-stage posterior pedicle screw and rod system orthopedic therapy in orthopaedic department of Fujian Provincial Hospital from 2011 to 2013. The patients who were included in the study, After operation, the full-length X-ray films of the spinal column were taken in the standing position, and in the supine position and the left and right bending position before the operation. The concept of vector was introduced to indicate the size and direction of the spinal column. Before and after the last follow-up, the deviation vector, principal convex vector, all lateral convex vector of coronal C7 plumb vertical C7PLs relative to the center of the sacral midline perpendicular line were observed. [results] 22 patients with AIS, 5 males and 17 females, had an average age of 14. 3 years or 12. 2 or 18. 0 years old. The mean follow-up was 12 months to 24 months. Before and after operation, the cobb angle of major scoliosis was 6 ~ 24 months. There were significant differences in the sum of the cobb angles of all scoliosis (P 0.05 t) and the correlation between the preoperative C7PL-CSVL vector and the preoperative main convex vector was statistically significant (P 0.05), and the sum of preoperative C7PL-CSVL vector and all preoperative scoliosis vectors was significantly correlated with the sum of all preoperative scoliosis vectors. Before and after operation, the size of C7PL-CSVL and the cobb angle of main scoliosis and the sum of C7PL-CSVL and all the lateral kyphosis (the sum of the cobb angle of each principal and secondary scoliosis) were not statistically correlated with the change of C7PL-CSVL, and there was no statistical correlation between C7PL-CSVL and C7PL-CSVL before and after operation, and there was no statistical correlation between C7PL-CSVL and C7PL-CSVL. There was no statistical correlation between the correction rate of principal scoliosis and the change rate of C7PL-CSVL (P 0.05). The focal point of the possible loss of balance of the trunk coronal plane in patients with AIS should be to prevent the deviation of the bulge direction from the trunk to the main and total scoliosis. There is no direct relationship between the angle of Cobb and the size of C7PL-CSVL on the coronal plane in AIS patients, and there is no direct relationship between the angle of Cobb and the size of C7PL-CSVL. There is no direct relationship between correction of main scoliosis and correction of coronal deviation of trunk.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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