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VCM技术和旋棒技术治疗Lenke5C青少年特发性脊柱侧凸的临床效果评估
  • ISSN号:1005-8478
  • 期刊名称:《中国矫形外科杂志》
  • 时间:0
  • 分类:R682.3[医药卫生—骨科学;医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]中山大学附属第一医院脊柱侧弯中心,广州510080
  • 相关基金:基金项目:中山大学5010项目(编号:2012003)
中文摘要:

[目的]比较Lenke5C青少年特发性脊柱侧凸(AIS)采用VCM技术(vertebralcolumnmanipulator)和旋棒技术(RD,rodderotation)矫正的临床效果。[方法]回顾性分析本院脊柱侧弯中心2008年7月-2012年8月收治的36例Lenke5CAIS患者,按去旋转矫正技术不同分为2组:VCM组26例,RD组15例,所有患者皆具有完整临床和影像资料。研究测量记录患者的10项影像参数,包括主弯顶椎旋转角及其矫正率,主弯Cobb角及其矫正率,主弯顶椎偏移(AVT),C,铅垂线偏移骶骨中央垂线距离(C7-CSVL),C,铅垂线偏移骶骨后上角距离(C7-SSVL),下融合椎倾斜角(LIV—tih)及其矫正率,下融合椎距稳定椎节段数(LIV—sV),并利用统计学独立样本t检验对两组病例术前、术后的影像参数进行比较。[结果]两组患者皆成功获得手术矫正,术中、术后无严重并发症发生。VCM组和RD组的顶椎旋转角旋转矫正率平均为52.2%和34.4%,两组术前顶椎旋转角无统计学差异(P〉0.05),术后顶椎旋转角及旋转矫正率具有明显统计学差异(P〈0.05);两组的主弯Cobb角矫正率平均为87.3%和82.4%,两组间无统计学差异(P〉0.05);两组的LIV—SV具有明显统计学差异(P〈0.05),VCM组明显大于RD组,其均值分别为(1.1±0.3)节和(0.84-0.4)节;两组的LIV—tilt角矫正率平均为77.2%和66.6%,组间无明显统计学差异(P〉0.05);两组患者术前、术后的冠状面和矢状面平衡皆得到良好维持。[结论]Lenke5CAIS采用VCM技术和旋棒技术矫形皆可获得良好的主弯和下融合椎倾斜角矫正及冠状面和矢状面平衡,但VCM技术术后即刻的顶椎旋转矫正和减少腰椎远端融合节段的趋势优于旋棒技术。

英文摘要:

[ Objective] To evaluate the radiographic outcomes of Lenke 5C patients treated by vertebral column manipula- tor (VCM) and rod derotation (RD) maneuver. [ Methods] A retrospective study was designed to compare 2 cohorts including 36 Lenke V patients treated by VCM and SRD techniques from July 2008 to Aug 2012. In VCM group, there were 24 AIS pa- tients, who were male 5 and female 19, with mean age ( 15.7±3.4) years. In RD group, 12 AIS patients who were male 3 and female 9, with mean age ( 17. 1±3.4) years. All patients had completed record and whole spine PA and lateral X - ray film be- fore and after operation, Ten radiographic variables of pre - operation and post - operation were collected and compared between two groups, including apical rotational angle and rotational corrective rate of main curve, Cobb angle and curve corrective rate of main curve, coronal C7 to center sacral vertical line (C7 -CSVL), the sagittal C7 to center sacral vertical line (C7 -SSVL), apical vertebral transition (AVT), lowest instrumented vertebra tilt (LIV -Tilt) angle and LIV -Tilt corrective rate, the seg- mental number between LIV and stable vertebra, and the segment between LIV and SV ( LIV - SV) . [ Results ] Scoliosis was successfully corrected in both groups. All patients got good coronal, sagittal balance and no severe complications happened during or after operation. The apical rotation corrective rate of VCM group and RD group were 52. 2% and 34.4%, with statisti- cally significant differences (P 〈 0. 05) . Main curve corrective rate of both groups were 87. 3% and 82.4%, without significant difference ( P 〉 0. 05 ) . The LIV - SV had statistically significant differences between VCM and RD group, mean were ( 1.1 ±0. 3 ) level and (0. 8 ± 0. 4) level ( P 〉 0. 05 ) . LIV - tilt angle correction rate of both groups had no statistically significant differ- ence, but the the VCM group's correction rate was higher than the RD group ( VCM group : RD group

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期刊信息
  • 《中国矫形外科杂志》
  • 北大核心期刊(2011版)
  • 主管单位:中国残疾人联合会
  • 主办单位:中国残疾人康复协会 中国人民解放军第八十八医院
  • 主编:
  • 地址:山东省泰安市环山路217-1号
  • 邮编:271000
  • 邮箱:zgjxwkzz@public.taptt.sd.cn;jiaoxing-tougao@163.com
  • 电话:0538-6213228
  • 国际标准刊号:ISSN:1005-8478
  • 国内统一刊号:ISSN:37-1247/R
  • 邮发代号:24-97
  • 获奖情况:
  • 中国科技论文统计源期刊,98,99年泰安市“十佳”期刊,山东省自然科学技术良好期刊
  • 国内外数据库收录:
  • 美国化学文摘(网络版),波兰哥白尼索引,美国剑桥科学文摘,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:54704