| 摘要: |
| 目的 提出一种新的评估青少年特发性脊柱侧凸（AIS）患者柔韧性的方法——生物力学在体反应特征曲线。方法 回顾性选择2017年11月至2018年6月在我院就诊的18例Lenke Ⅰ型AIS患者，其中女16例、男2例，年龄为10~17岁，初始主胸弯冠状面Cobb角为40.00°~63.00°，平均主胸弯冠状面Cobb角为（44.50±6.35）°。利用体外脊柱侧凸Cobb角测量仪评估自然重力状态下患者主胸弯冠状面Cobb角，之后从0 N开始逐渐增加纵向牵引力至160 N，每增加20 N对主胸弯冠状面Cobb角进行1次评估。对每例患者的主胸弯冠状面Cobb角与纵向牵引力进行Pearson相关和线性回归分析，并计算回归系数（动态柔韧指数，K），绘制生物力学在体反应特征曲线。结果 18例Lenke Ⅰ型AIS患者的主胸弯冠状面Cobb角均随着纵向牵引力的增大而减小，Pearson相关分析结果显示每例患者的主胸弯冠状面Cobb角均与纵向牵引力呈负相关（P均<0.05）。18例Lenke Ⅰ型AIS患者动态柔韧指数（K）为-0.239~-0.098，与患者年龄、身高、体重、BMI、Risser征均无明显相关性（P均>0.05），而与初始主胸弯冠状面Cobb角呈负相关（r=-0.704，P=0.001）。结论 Lenke Ⅰ型AIS患者生物力学在体反应特征曲线是评估脊柱侧凸柔韧性的一种有效方法，并且能动态全面评估整体柔韧性。 |
| 关键词: 青少年特发性脊柱侧凸 柔韧性 生物力学 在体反应特征曲线 |
| DOI：10.16781/j.0258-879x.2020.11.1203 |
| 投稿时间：2019-04-24修订日期：2020-02-13 |
| 基金项目:国家自然科学基金（31870985），上海市自然科学基金（16ZR1449100）. |
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| In vivo biomechanical response characteristic curve in Lenke type Ⅰ adolescent idiopathic scoliosis |
| BAI Jin-yi△,LI Bo△,ZHAO Yun-fei,ZHAO Ying-chuan,LI Ming,YANG Chang-wei* |
(Department of Orthopaedics, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To introduce a new method to evaluate the flexibility of adolescent idiopathic scoliosis (AIS)-in vivo biomechanical response characteristic curve. Methods A total of 18 patients with Lenke type Ⅰ AIS from Nov. 2017 to Jun. 2018 in our hospital were retrospectively selected; the patients included 16 females and two males, aged from 10 to 17 years old. The initial coronal Cobb angle of the main thoracic curve was 40.00° to 63.00°, averaging at (44.50±6.35)°. The coronal Cobb angle of the main thoracic curve was evaluated by the extracorporeal scoliosis Cobb angle measuring instrument under natural gravity, and then the longitudinal traction force was gradually increased from 0 N to 160 N, with the coronal Cobb angle of the main thoracic curve evaluated every 20 N. Pearson correlation and linear regression analysis were used to analyze the coronal Cobb angle and longitudinal traction for each patient. The regression coefficient (dynamic flexibility index, K) was calculated and the in vivo biomechanical response characteristic curve was drawn. Results The coronal Cobb angle of the main thoracic curve decreased with the increase of longitudinal traction in 18 patients with Lenke type Ⅰ AIS. Pearson correlation regression analysis showed that the coronal Cobb angle of the main thoracic curve in each patient was negatively correlated with the longitudinal traction force (all P<0.05). The K values of the 18 Lenke type Ⅰ AIS patients were -0.239 to -0.098, and K value had no significant correlation with age, height, body weight, body mass index or Risser sign (all P>0.05), but had a negative correlation with the coronal Cobb angle of the initial main thoracic curve (r=-0.704, P=0.001). Conclusion In vivo biomechanical response characteristic curve is an effective method to evaluate the flexibility of scoliosis for Lenke type Ⅰ AIS, and it can dynamically and comprehensively evaluate the overall flexibility. |
| Key words: adolescent idiopathic scoliosis flexibility biomechanics in vivo response characteristic curve |
