摘要
[目的]通过影像学测量脊柱高度和胸廓容积变化,评估生长棒技术治疗先天性脊柱侧凸对胸廓发育的影响。[方法]分析2010年7月~2016年7月本院23例应用生长棒技术治疗的先天性脊柱侧凸患儿的完整资料,测量术前、初次及各次撑开术后和末次随访时脊柱全长正侧位X线片脊柱和胸廓发育相关参数指标,包括主胸弯Cobb角、T_1~T_(12)高度、胸椎后凸角度、胸廓前后径和矢状纵径、胸廓最大宽度、坎贝尔空间供肺比值,并进行统计学分析。[结果]初次及各次撑开术后和末次随访时,主胸弯Cobb角、TK、T_1~T_(12)高度、胸廓最大宽度、胸廓前后径和矢状纵径以及SAL均较术前差异有统计学意义(P<0.05);术前到末次随访主胸弯Cobb角变化值与T_1~T_(12)高度(r=0.584,P<0.05)、胸廓矢状高度(r=.0594,P<0.05)及SAL的变化值间(r=0.693,P<0.05)呈正相关;随撑开次数增加,各项胸廓发育参数变化曲线先显著增加后逐渐趋于平缓。[结论]利用生长棒技术治疗先天性脊柱侧凸,不仅能够矫正脊柱畸形、保留脊柱生长潜能,还可以调整左右胸廓的高度差和不对称性,增加胸廓容积容量,但随着撑开次数增加,这种效应逐渐趋于减弱。
[Objective] To evaluate the effect of growing rod technique on chest volume in the treatment of congenital seoliosis based on the radiographic images. [Methods] From July 2010 to July2016, 23 patients with congenital scoliosis underwent surgical treatment by growing rod technique in our center. Radiographic parameters associated with chest volume and thoracic spine were measured on anteroposterior and lateral standing radiograph of the whole spine, including the Cobb angle of main thoracic curve, thoracic kyphosis （TK） , Tt-12 height, thoracic anteroposterior diameter, thoracic sagittal longitudinal di- ameter, maximal chest width, Campbell＇ s space available for lung ratio （SAL） . The data at each follow-up time point were recorded and statistically analyzed. [Results] The Cobb angle of main thoracic curve, TK, TH2height, chest anteroposterior diameter, sagittal longitudinal diameter, maximal chest width and SAL after each of distraction procedures and at the latest followup, increased significantly compared with those preoperatively （P〈0.05） . In term of variations of these parameters from the preoperative to the final follow up, the Cobb angle proved positive correlations with the Tl-t2 height （r=0.584, P 〈 0.05） , the chest sagittal height （r=0.594, P 〈 0.05） and the SAL （r=0.693, P 〈 0.05） . Curved line of the chest volume parameter varied from rapid alteration to fiat as distraction times increased. [ Conclusions ] The application of growing rod technique for the treatment in congenital scoliosis is not only correcting the spinal deformity and preserving spine growth potentials, but also adjusting unbalanced heights of asymmetrical skeletal chest and restoring chest volume, however, above effects tend to decline with the increase of times of distraction procedures.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第21期1949-1953,共5页
Orthopedic Journal of China
基金
国家自然科学基金青年项目(编号:81601858)
关键词
先天性脊柱侧凸
生长棒技术
胸廓发育
影像学
congenital scoliosis, growing rod tech-nique, chest volume, radiographic image
