Hackenberg L, Liljenqvist U, Hierholzer E, Halm H
Klinik und Poliklinik für Allgemeine Orthopädie, Westfälischen Wilhelms-Universität Münster.
Z Orthop Ihre Grenzgeb. 2000 Jul-Aug;138(4):353-9. doi: 10.1055/s-2000-10162.
So far only radiometric and clinical methods have been available for the evaluation of results after anterior scoliosis surgery. Rasterstereography has proved to be a reliable method for three-dimensional surface measurement of conservatively treated idiopathic scoliosis patients. Therefore, patients treated operatively with anterior instrumentation were examined using rasterstereography to determine the three-dimensional correction of the spinal deformity. The aim was to measure back shape deformity, in particular derotation, and thus cosmetic improvements.
31 patients with idiopathic thoracic, thoracolumbar and lumbar scoliosis (Cobb angle 57.2 degrees) were examined with raster stereography preoperatively, postoperatively and after follow-up (25.2 months) in a standardized standing posture. Standing radiographs were compared with raster stereography.
The mean Cobb angle was reduced from 57.2 degrees to 17.2 degrees, the rasterstereographic maximal surface rotation from 16.5 degrees to 10.8 degrees, and the vertebral rotation according to Perdriolle from 29.2 degrees to 16.7 degrees. During follow-up the Cobb angle increased to 20.8 degrees, and surface rotation to 11.3 degrees. Vertebral rotation remained constant. Lordosis and kyphosis angles changed only slightly.
Rasterstereography is a suitable tool for analyzing the three-dimensional correction of spinal deformities after anterior scoliosis surgery. In particular, the cosmetic improvement is clearly demonstrated. The measurement of surface rotation allows objective quantification of the obtained derotation.
到目前为止,对于前路脊柱侧弯手术后结果的评估,仅有放射测量法和临床方法可用。光栅立体摄影已被证明是一种用于保守治疗的特发性脊柱侧弯患者三维表面测量的可靠方法。因此,我们使用光栅立体摄影对接受前路器械治疗的患者进行检查,以确定脊柱畸形的三维矫正情况。目的是测量背部形状畸形,尤其是去旋转情况,从而评估外观改善情况。
对31例患有特发性胸段、胸腰段和腰段脊柱侧弯(Cobb角57.2度)的患者,在术前、术后以及随访(25.2个月)时以标准化站立姿势进行光栅立体摄影检查。将站立位X线片与光栅立体摄影结果进行比较。
平均Cobb角从57.2度降至17.2度,光栅立体摄影测量的最大表面旋转角度从16.5度降至10.8度,根据Perdriolle法测量的椎体旋转角度从29.2度降至16.7度。在随访期间,Cobb角增加至20.8度,表面旋转角度增加至11.3度。椎体旋转角度保持不变。脊柱前凸和后凸角度仅略有变化。
光栅立体摄影是分析前路脊柱侧弯手术后脊柱畸形三维矫正情况的合适工具。特别是,外观改善情况得到了清晰展示。表面旋转的测量能够客观量化所获得的去旋转程度。