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背景:站立侧屈、仰卧侧屈、侧方按压、俯卧推压和牵引下摄X射线片对预测哈氏法和卢氏法手术的矫正效果确实有效,但均不能更好地预测目前应用的三维椎弓根钉棒矫形系统的矫正效果。目的:评估术前支点弯曲位、重力悬吊牵引位和仰卧侧屈位X射线平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。设计:对比观察。单位:解放军第二一一医院骨科(全军骨科中心)。对象:选择2003-01/2005-12解放军第二一一医院骨科就诊的63例青少年特发性脊柱侧凸患者,男18例,女45例,年龄10￣21岁。均经临床检查及X射线平片诊断为青少年特发性脊柱侧凸;Cobb角≥40°;患者均对检测项目知情同意。方法:术前对63例青少年特发性脊柱侧凸患者的79个结构性侧凸摄站立位全脊柱正侧位片、支点弯曲位片、重力悬吊牵引位片和仰卧侧屈位片,术后1周时摄站立位全脊柱正侧位片。主要观察指标:青少年特发性脊柱侧凸术前支点弯曲位Cobb角与术后实际Cobb角。结果:患者63例均进入结果分析。术前支点弯曲位Cobb角与术后站立位比较,差异无显著性意义(P>0.05);而术前重力悬吊牵引位和仰卧侧屈位Cobb角与术后站立位比较,差异有显著性意义(P<0.05)。结论:支点弯曲位X射线平片比重力悬吊牵引位和仰卧侧屈位X射线平片能更准确地预测术后矫正效果,而重力悬吊牵引位与仰卧侧屈位摄片的预测结果相似。
BACKGROUND: The effects of orthoptic, supine lateral flexion, lateral compression, prone pressure and traction radiographs on the prediction of Hastelloy’s and Romer’s procedures are indeed valid, but none of them are better predictors of current Correction effect of three dimensional pedicle screw rod orthopedic system. OBJECTIVE: To assess the value of preoperative fulcrum bending, gravitational suspension traction and supine lateral flexion radiography in predicting the effect of three-dimensional orthopedic fusion for adolescent idiopathic scoliosis. Design: comparative observation. Unit: Second Hospital of PLA, orthopedic (PLA orthopedic center). PARTICIPANTS: 63 adolescents with idiopathic scoliosis were selected from the orthopedics department of the 211st Hospital of PLA from January 2003 to December 2005, including 18 males and 45 females, aged from 10 to 21 years old. Both were diagnosed as adolescent idiopathic scoliosis by clinical examination and X-ray film; Cobb angle ≥40 °; patients were informed consent of the test items. Methods: A total of 79 structural scoliosis patients in 63 adolescent idiopathic scoliosis patients underwent preoperative full spine orthosis, fulcrum bending, gravitational suspension traction and supine lateral flexion, At 1 week after surgery, the whole body of the spine was taken upright. MAIN OUTCOME MEASURES: Cobb angle of preoperative fulcrum of adolescent idiopathic scoliosis and postoperative actual Cobb angle. Results: 63 patients were involved in the result analysis. There was no significant difference between preoperative flexion Cobb angle and postoperative standing position (P> 0.05), but there was a significant difference between preoperative gravitational pull traction position and supine lateral flexion Cobb angle and postoperative standing position Sexual significance (P <0.05). CONCLUSION: X-ray plain radiographs of fulcrums can predict the effect of postoperative correction more accurately than that of gravity suspension traction and supine lateral flexion radiographs. However, the predicted results of gravity suspension traction and supine lateral flexion radiographs similar.