• 医学文献
  • 知识库
  • 评价分析
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
论文 期刊
高级检索

检索历史 清除

胸弯型青少年特发性脊柱侧凸术前胸椎后凸对术后矢状面代偿模式的影响

Influence of preoperative thoracic kyphosis on the sagittal profile of the lumbar spine in idiopathic thoracic scoliosis following selective thoracic fusion

摘要:

目的 探讨胸弯型青少年特发性脊柱侧凸 (AIS) 患者选择性胸椎融合术前胸椎矢状面 形态对术后矢状面代偿模式的影响.方法 回顾性分析1999年2月至2005年12月行前路或后路 选择性胸椎融合术且有完整随访资料的90例 AIS患者的临床资料,其中男性15例,女性75例;年龄 11-18岁,平均(14.5±1.9)岁;前路手术41例,后路手术49例.根据术前胸椎后凸角(TK)大小,再 将前后路手术患者分别分为TK<10°组和TK≥10°组.对这四组患者术前及术后随访的胸弯侧凸 角、腰弯侧凸角、TK、腰椎前凸角(LL)、内固定远端交界性后凸角(DJK)、胸腰段交界性后凸(TJK)及 骶骨后上缘与C_7,铅垂线的距离 (SVA) 等指标进行测昔并进行统计学分析.结果 末次随访时,前路 TK<10°组TK、TJK和 DJK均较术前增大,差异具有统计学意义(P<0.05),总体上由前凸变成后凸; 前路TK≥10°组TK 较术前无明显变化,DJK虽有增大的趋势,但差异无统计学意义(P>0.05),而 TJK 较术前增大,差异有统计学意义(P<0.05);后路TK<10°组TK、TJK均较术前增大,差异有统计 学意义(P<0.05),DJK虽有增大的趋势,但差异无统计学意义(P>0.05)°后路TK≥10°组TK、TJK 和DJK在随访过程中均无明显变化.末次随访时全部TK<10°患者LL与术前相比差异虽无统计学 意义,但总体上呈现逐渐增大的趋势.而四组患者术后的SVA与术前相比无明显变化且均保持在正 常范围.结论 术前TK减少的胸弯型AIS患者行选择性胸椎融合术后,TK、LL均获良好蕈建.但 术后随访过程中DJK和TJK有后凸增大趋势,可能与前路内固定节段短及术后矢状面的重建有关.

更多
abstracts:

Objective To analyze the influence of thoracic kyphosis on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after the selective thoracic fusion.Methods Ninety AIS patients(mean age 14.5 years old) who received selective thoracic fusion from February 1999 to December 2005 in one institution with at least 24-month follow-up were evaluated.Forty-one patients underwent anterior spinal fusion and forty-nine patients underwent posterior spinal fusion.And then the patients were divided into two subgroups according to the magnitude of preoperative thoracic kyphosis(TK):Group A,TK less than 10°:and Group B,TK more than 10°.The radiological parameters were measured including: thoracic and lumbar curve magnitude,TK,lumbar lordosis(LL),thoracolumbar junction kyphosis(T_(10)-L_2,TJK),distal junctional kyphosis(DJK),sagittal vertical axis(SVA).Results At final follow-up,TK,TJK and DJK increased significantly compared with preoperative Cobb angle in subgroup A patients who underwent anterior spinal fusion(P<0.05).Generally,there was a lordosis loss of TJK and DJK during follow-up.While in subgroup B,TJK at final follow-up increased apparently compared with preoperative Cobb angle(P<0.05).And there was a increased trend of DJK in spite of no significant difiefence, however, there was no obvious change of TK in subgroup B.At the final follow-up.TK and TJK increased significantly in subgroup A patients who underwent posterior spinal fusion(P<0.05).And there was a increased tendency of DJK during follow-up,although there was no significant difierence.And there was no obvious change of TK.TJK and DJK in subgroup B.There was a increased trend of LL in spite of no significant difference in group A patients who underwent anterior or posterior spinal fusion.The sagittal balance maintained well during follow-up in both groups.Conclusions For AIS patients with thoracic bypokyphosis.normal TK and LL could be achieyed during follow-up with selective thoracic instrumentation. However,the increase of DJK and TJK may occur during the follow-up,and the risk factors may be the anterior short segmental fusion and the reconstruction of the sagittal profile in the hypokyphosis patients.

More
作者: 曹兴兵 [1] 邱勇 [2] 朱泽章 [2] 殷刚 [2] 李卫国 [2] 刘臻 [2] 王玉 [2]
第一作者: 曹兴兵
期刊: 《中华外科杂志》2010年48卷1期 22-25页 MEDLINEISTICPKUCSCD
分类号: R6
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2010.01.005
发布时间: 2010-03-23
基金项目:
江苏省卫生厅重点项目
  • 浏览:153
  • 下载:19

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

充值 订阅 收藏 移动端 使用
帮助