| 摘要: |
| 目的 通过对比分析牵引下仰卧位全脊柱拼接X线片与站立位全脊柱拼接X线片测量数据，评估两者对中重度脊柱侧凸患者术前手术方案选择的指导价值。方法 回顾性选择2021年1月至12月在海军军医大学（第二军医大学）第二附属医院因脊柱侧凸就医并拍摄牵引下负重仰卧位全脊柱（颈椎-胸椎-腰椎-骨盆）正侧位X线片的中重度脊柱侧凸患者，经过纳入标准筛选共纳入82例患者。记录患者的年龄、性别、术前站立位与牵引下负重仰卧位及术后站立位的全脊柱Cobb角、手术方案、术后Cobb角矫正率、脊柱柔韧度。将患者分为脊柱柔韧度≥30%组和脊柱柔韧度＜30%组，分析脊柱柔韧度与术后矫正率、矫形手术方案选择的关系。结果 82例患者中女57例、男25例，年龄为6～63岁，平均年龄为（23.0±14.3）岁。术前Cobb角为（69.90±27.74）°，牵引下Cobb角为（42.33±30.31）°，术后Cobb角为（13.53±14.87）°，术后Cobb角矫正率为（80.90±17.36）%。脊柱柔韧度≥ 30%组的术后Cobb角矫正率高于脊柱柔韧度＜30%组［（86.97±15.39）% vs （74.41±17.74）%；t＝2.802，P＝ 0.011］。脊柱柔韧度≥30%组、＜30%组接受截骨矫形手术的患者占比分别为61.0%（25/41）、80.5%（33/41），差异接近有统计意义（χ2＝3.770，P＝0.052）。结论 对于中重度脊柱侧凸患者，术前牵引下负重仰卧位及站立位全脊柱X线拍摄可提供其脊柱柔韧度及Cobb角等数据，有助于指导手术方案的选择。 |
| 关键词: 牵引 Cobb角 脊柱侧凸 矫形手术 脊柱柔韧性 |
| DOI：10.16781/j.CN31-2187/R.20220436 |
| 投稿时间：2022-05-22修订日期：2022-09-02 |
| 基金项目: |
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| Value of whole spine scanography with supine position under traction in preoperative evaluation of moderate to severe scoliosis correction |
| JIA Yi-ming1△,LI Li2△,DUAN Guang-wen1,NI Jing1,ZHANG Rong1,LIU Shi-yuan1* |
(1. Department of Radiology, The Second Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Department of Radiology, Tenth People's Hospital of Tongji University, Shanghai 200072, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To assess the value of the whole spine scanography with supine position under traction and the whole spine scanography with erect position in guiding the preoperative surgical plan for patients with moderate to severe scoliosis by comparing and analyzing the data of the 2 methods. Methods Patients with moderate to severe scoliosis who visited The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. to Dec. 2021 and had weight-bearing supine whole spine positive and lateral radiographs under traction were retrospectively selected, and a total of 82 patients were included after screening by inclusion criteria. The patients’ age, gender, preoperative erect position, weight-bearing supine position under traction and postoperative erect position whole spine Cobb angles, surgical options, postoperative Cobb angle correction rate and spinal flexibility were analyzed. The patients were divided into groups with spinal flexibility≥30% and spinal flexibility＜30%, and the relationships between spinal flexibility and postoperative correction rate, as well as the selection of orthopedic surgery options, were analyzed. Results Among the 82 patients, 57 were female and 25 were male, aged from 6 to 63 years, with an average age of (23.0±14.3) years. The preoperative Cobb angle was (69.90±27.74)°, the Cobb angle was (42.33±30.31)°under traction, postoperative Cobb angle was (13.53±14.87)°, and postoperative Cobb angle correction rate was (80.90±17.36) %. The postoperative Cobb angle correction rate in the group with spinal flexibility≥30% was higher than that in the group with spinal flexibility＜30% (［86.97±15.39］% vs ［74.41±17.74］%; t＝2.802, P＝0.011). The proportions of patients in the spinal flexibility≥30% and ＜30% groups receiving osteotomy and orthopedic surgery were 61.0% (25/41) and 80.5% (33/41), respectively (χ2＝3.770, P＝0.052). Conclusion For patients with moderate to severe scoliosis, preoperative weight-bearing whole spine scanography with supine position under traction and whole spine scanography with erect position can provide data such as spinal flexibility and Cobb angle for the selection of surgical options. |
| Key words: traction Cobb angle scoliosis orthopedic surgery spinal flexibility |
