Lenke 1C型青少年特发性脊柱侧凸选择性融合术后参数变化

发布时间：2018-05-02 03:30

本文选题：青少年特发性脊柱侧弯 + 椎弓根螺钉　；参考：《中国矫形外科杂志》2017年19期

【摘要】：[目的]研究经椎弓根螺钉内固定选择性融合术后Lenke 1C型AIS患者矢状面参数的变化及与冠状面参数或骨盆参数之间的相关关系。[方法]选择41例连续观察的Lenke 1C型特发性脊柱侧凸患者,均行后路椎弓根螺钉固定、选择性融合术。术后随访2年。术前、术后2个月、术后2年均行站立位全脊柱正侧位X线片检查,并行影像学测量与统计。[结果]平背畸形组(胸椎后凸角20°)患者,术后2个月(19.59±9.59)°、2年(20.45±3.59)°与术前(11.82±3.32)°比较,胸椎后凸角明显增加(P=0.010),术后2个月与2年比较,胸椎后凸角能保持稳定(P=0.998)。胸椎后凸角术后2年变化量与腰椎前凸角2年变化量、术前腰椎前凸角、骨盆投射角呈显著性相关(r值分别为-0.652,0.635,0.805,P值分别为0.041,0.049,0.005)。[结论]椎弓根螺钉内固定系统能改善平背畸形Lenke1C型患者的胸椎后凸。选择性融合术中,胸椎后凸的纠正在维持脊柱矢状位平衡中发挥重要作用。
[Abstract]:[objective] to study the changes of sagittal parameters and their correlation with coronal or pelvic parameters in patients with Lenke 1C type AIS after selective fusion of pedicle screw fixation. [methods] 41 consecutive patients with Lenke 1C idiopathic scoliosis were treated with posterior pedicle screw fixation and selective fusion. Postoperative follow-up was 2 years. Before, 2 months after operation, 2 years after operation, the standing position of the whole spine was examined by X-ray, and the imaging measurement and statistics were performed. [results] in the flat dorsal deformity group (20 掳of thoracic kyphosis), the posterior kyphosis angle of thoracic vertebrae increased significantly 2 months after operation by 19.59 卤9.59 掳and 20.45 卤3.59 掳at 2 months after operation compared with 11.82 卤3.32 掳preoperatively. The kyphosis angle of thoracic spine kept stable at 2 months after operation compared with 2 years after operation. The changes of thoracic kyphosis angle and lumbar kyphosis angle were significantly correlated with lumbar kyphosis angle and pelvic projection angle respectively (P = 0.041, 0.049 and 0.005, P = -0.6520.635and 0.805P, respectively). [conclusion] the pedicle screw internal fixation system can improve thoracic scoliosis in Lenke1C patients with flat dorsal deformity. Correction of thoracic kyphosis plays an important role in maintaining sagittal balance of spine in selective fusion.
【作者单位】：上海长征医院脊柱四科;
【分类号】：R726.8

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