3种摄片方法预测青少年特发性脊柱侧凸矫形结果对比探究.docVIP

3种摄片方法预测青少年特发性脊柱侧凸矫形结果对比探究 　【摘要】 评估术前站立位、支点弯曲位、重力悬吊牵引位和仰卧侧屈位X线片在预测青少年特发性脊柱侧凸三维矫形融合术效果的价值。［方法］对63例青少年特发性脊柱侧凸患者的79个结构性侧凸摄术前站立位、支点弯曲位、重力悬吊牵引位和仰卧侧屈位X线片，将其与术后的站立位X线片比较，测量全部Cobbs角后进行统计学处理，并评估其价值。［结果］结构性胸凸组与结构性腰凸组重力悬吊牵引位片Cobbs角分别是40°和21°，仰卧侧屈位片Cobbs角分别是41°和23°，支点弯曲位片Cobbs角分别是35°和19°，术后站立位片Cobbs角分别是36°和18°；重度组（≥60°）与中度组（＜60°）重力悬吊牵引位片Cobbs角分别是52°和23°，仰卧侧屈位片Cobbs角分别是53°和24°，支点弯曲位片Cobbs角分别是47°和20°，术后站立位片Cobbs角分别是44°和19°；僵硬组与柔软组重力悬吊牵引位片Cobbs角分别是51°和22°，仰卧侧屈位片Cobbs角分别是52°和22°，支点弯曲位片Cobbs角分别是48°和18°，术后站立位片Cobbs角分别是45°和17°；前路手术组与后路手术组重力悬吊牵引位片Cobbs角分别是47°和15°，仰卧侧屈位片Cobbs角分别是49°和16°，支点弯曲位片Cobbs角分别是43°和11°，术后站立位片Cobbs角分别是42°和10°，以上角度均为平均值。平均随访时间是1.5年（11~37个月）。［结论］支点弯曲位X线片比重力悬吊牵引位和仰卧侧屈位X线片能更准确地预测术后矫正效果，并能为选择前路或后路术式，以及融合节段提供依据。 【关键词】 青少年特发性脊柱侧凸 影像学 柔韧性 脊柱融合 Comparative analysis of three radiographic way in prediction of correction of adolescent idiopathic scoliosis∥CHEN Qinghe,ZHOU Yue,GAO Jichang,et al.The Orthopaedic Department of Xinqiao Hospital of the Third Military Medical University,Chongqing 400037,China Abstract：［Objective］To evaluate the role of three radiographic ways in patients undergoing spinal threedimensional correction and fusion for adolescent idiopathic scoliosis.［Method］Sixtythree cases of adolescent idiopathic scoliosis（AIS）with 79 structural curves were studied.Preoperative Xray of standing,gravitysuspendig traction,supine bending and fulcrum bending were compared with postoperative standing Xray one week after surgery,Cobbs angle of all Xray were measured and statistical significance was evaluated.［Result］In structural thoracic group and lumbar group the mean Cobbs angle were 40°and 21°in gravitysuspendig traction Xray,41°and 23°in supine bending Xray,35°and 19°in fulcrum bending Xray,36°and 18°in postoperative standing Xray respectively.In severe group and moderate group the mean Cobbs angle were 52°and 23°in gravitysuspendig traction Xray,53°and 24°in supine bending Xray,47°and 20°in fulcrum bending Xray,44°and 19°in post