LenkeⅡ型青少年特发性脊柱侧凸患者内固定冠状面失衡的相关因素分析

目的:探讨Lenke II型青少年特发性脊柱侧凸患者内固定冠状面失衡相关因素分析。方法:选取我院骨科已确诊为Lenke II青少年特发性脊柱侧凸患者60例,根据术前脊柱柔韧度、risser分级水平、支具支持治疗、椎体融合数、内固定系统选择等多方面影响因素对内固定后冠状面失平衡情况发生率进行分析评估,其数据结果应用统计学软件SPSS 17.0处理。结果:对术后患者评估比较,多种因素均可影响内固定后冠状面失平衡情况发生,表现为:脊柱柔韧度低、risser分级高、长时间支具佩戴、延长融合椎体范围、先进钉棒系统方案选择均可明显提高术后疗效,降低内固定后冠状面失平衡情况发生率(P0.05),其结果均有统计学意义。结论:临床上通过对患者脊柱柔韧度、risser分级情况评估来判断脊柱成熟度,并在术后积极支具辅助治疗,选用钉棒固定系统并延长融合椎体节段,可明显降低内固定后冠状面失平衡情况发生,提高远期随访疗效。

Study on the Relative Factors of the Imbalance of the Coronal Plane in LenkeII Type of Adolescent Idiopathic Scoliosis

Objective:To investigate the relative factors of the imbalance of the coronal plane in LenkeII type of adolescent idiopathic scoliosis (AIS).Methods:60 cases of AIS patients diagnosed as teenager LenkeII AIS were selected. The influence factors on internal fixed coronal plane imbalance situation occurrence rate were analyzed and evaluated based on preoperative spinal flexibility, Risser level classification, bracing treatment, vertebral body fusion number and internal fixation system. The results were then analyzed by Statistical software SPSS 17.0.Results:Analysis on assessments of postoperative patients indicated demostrated that multiple factors may affect the internal fixation and the imbalance of the coronal plane. Result indicated that preoperative low spinal flexibility, high risser grade, long-term bracing usage, extended fusion vertebral range and advanced screw rod systemplan all showed improved effects on success of postoperative recovery and significantly decreased occurrence rate of coronal plane imbalance after internal fixation(P<0.05).Conclusion:Prior evaluation of spinal maturity through the assessment of spinal flexibility and Risser grade, further active postoperative bracing treatment, the selection of nail-stick fixation system and extension of the fusion to the vertebral segment may significantly reduce the internal fixed coronal imbalance situation and improve the long-termfollow-up effects.