本文關鍵詞： 青少年特發(fā)性脊柱側凸 椎弓根釘-棒系統(tǒng) 軀干冠狀面平衡 側凸 向量　出處：《福建醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：【目的】探究青少年特發(fā)性脊柱側凸(adolescent idiopathic scoliosis,AIS)患者主側凸向量、總體側凸向量對手術前后軀干冠狀面平衡(coronal trunk balance,CTB)的影響�！痉椒ā炕仡櫺苑治�2011~2013年福建省立醫(yī)院骨科采用一期單純后路椎弓根釘-棒系統(tǒng)矯形治療的22例AIS患者。納入研究的患者術前、術后均拍攝站立位的脊柱全長正側位X光片,術前拍攝仰臥位左右bending位X光片。引入物理中表示大小和方向的向量概念,對術前和術后末次隨訪時冠狀面C7鉛垂線(C7 plumb line,C7PL)相對于骶骨中垂線(center sacral vertical line,CSVL)的偏移向量、主側凸向量、所有側凸(各主、次側凸)向量之和等參數(shù)進統(tǒng)計分析�！窘Y果】22例AIS患者,男5例,女17例,術時平均年齡14.3歲(12.2~18.0歲),平均隨訪12個月(6~24個月)。手術前后,主側凸cobb角、所有側凸cobb角之和、C7PL-CSVL大小的差異有統(tǒng)計學意義(P0.05,t值分別為9.37、2.21、8.56)。術前C7PL-CSVL向量與術前主側凸向量有統(tǒng)計學相關性(r=0.447,P0.05),術前C7PL-CSVL向量與術前所有側凸向量之和有統(tǒng)計學相關性(r=0.510,P0.01)。手術前后,C7PL-CSVL大小與主側凸cobb角大小、C7PL-CSVL大小與所有側凸(各主次側凸)cobb角大小之和無統(tǒng)計學相關性(P0.05)。主側凸校正量與C7PL-CSVL變化量、主側凸矯正率與C7PL-CSVL變化率無統(tǒng)計學相關性(P0.05)�！窘Y論】干預(支具、手術)AIS患者可能出現(xiàn)的軀干冠狀面失平衡的重點應該是防止軀干整體向主側凸和總體側凸的凸出方向偏移。AIS患者側凸Cobb角與冠狀面C7PL-CSVL大小無直接關系,主側凸的矯正與軀干冠狀面偏移的矯正無直接關系。
[Abstract]:[objective] to investigate the principal scoliosis vector of adolescent idiopathic scoliosis in Adolescent idiopathic scoliosisa. Effect of total scoliosis vector on coronal trunk before and after operation. [methods] A retrospective analysis was made on 22 cases of AIS treated by one-stage posterior pedicle screw and rod system orthopedic therapy in orthopaedic department of Fujian Provincial Hospital from 2011 to 2013. The patients who were included in the study, After operation, the full-length X-ray films of the spinal column were taken in the standing position, and in the supine position and the left and right bending position before the operation. The concept of vector was introduced to indicate the size and direction of the spinal column. Before and after the last follow-up, the deviation vector, principal convex vector, all lateral convex vector of coronal C7 plumb vertical C7PLs relative to the center of the sacral midline perpendicular line were observed. [results] 22 patients with AIS, 5 males and 17 females, had an average age of 14. 3 years or 12. 2 or 18. 0 years old. The mean follow-up was 12 months to 24 months. Before and after operation, the cobb angle of major scoliosis was 6 ~ 24 months. There were significant differences in the sum of the cobb angles of all scoliosis (P 0.05 t) and the correlation between the preoperative C7PL-CSVL vector and the preoperative main convex vector was statistically significant (P 0.05), and the sum of preoperative C7PL-CSVL vector and all preoperative scoliosis vectors was significantly correlated with the sum of all preoperative scoliosis vectors. Before and after operation, the size of C7PL-CSVL and the cobb angle of main scoliosis and the sum of C7PL-CSVL and all the lateral kyphosis (the sum of the cobb angle of each principal and secondary scoliosis) were not statistically correlated with the change of C7PL-CSVL, and there was no statistical correlation between C7PL-CSVL and C7PL-CSVL before and after operation, and there was no statistical correlation between C7PL-CSVL and C7PL-CSVL. There was no statistical correlation between the correction rate of principal scoliosis and the change rate of C7PL-CSVL (P 0.05). The focal point of the possible loss of balance of the trunk coronal plane in patients with AIS should be to prevent the deviation of the bulge direction from the trunk to the main and total scoliosis. There is no direct relationship between the angle of Cobb and the size of C7PL-CSVL on the coronal plane in AIS patients, and there is no direct relationship between the angle of Cobb and the size of C7PL-CSVL. There is no direct relationship between correction of main scoliosis and correction of coronal deviation of trunk.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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