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脊柱矫形器治疗青少年特发性脊柱侧凸(AIS)的有效性及生物力学

Effectiveness and biomechanics of spinal orthoses in the treatment of adolescent idiopathic scoliosis (AIS).

作者信息

Wong M S, Mak A F, Luk K D, Evans J H, Brown B

机构信息

The Hong Kong Polytechnic University, Rehabilitation Engineering Centre, China.

出版信息

Prosthet Orthot Int. 2000 Aug;24(2):148-62. doi: 10.1080/03093640008726538.

Abstract

In this prospective study, the effectiveness and biomechanical factors of spinal orthoses in the treatment of moderate adolescent idiopathic scoliosis (AIS) patients were investigated. In the first 20 months of orthotic treatment, the values of standing AP Cobb's angle, apical vertebral rotation, lumbar lordosis as well as thoracic kyphosis showed significant reduction (P<0.05), however, the angle of trunk inclination and trunk listing did not. The values of those reducible parameters reached their lowest values within the first 12 months of orthotic treatment and then the values gradually increased but they were still below the pre-brace values. The mean pressure of The pressure pads was found to be 7.09 +/- 1.77 kPa (53.2 +/- 13.3 mmHg) while the mean tension of the straps was 26.8 +/- 5.2N. The standing AP Cobb's angle strongly correlated with the pad pressure (correlation coefficient=0.931, p<(.05) and strap tension (correlation coefficient=0.914, p<0.05). The strap tension and pad pressure strongly correlated and the correlation coefficient was 0.873 (p<0.05). This suggests that in the consideration of biomechanical function of spinal orthoses, the focus may be upon how tightly the orthosis was fastened and if the location and direction of the pressure pads are the correct. Therefore, for enhancing independent standard tension should be set in each strap, and regular and close monitoring is needed.

摘要

在这项前瞻性研究中,研究了脊柱矫形器治疗中度青少年特发性脊柱侧凸(AIS)患者的有效性和生物力学因素。在矫形治疗的前20个月,站立位前后位Cobb角、顶椎旋转度、腰椎前凸以及胸椎后凸的值均显著降低(P<0.05),然而,躯干倾斜角和躯干侧倾角度并未降低。这些可降低参数的值在矫形治疗的前12个月内达到最低值,然后逐渐升高,但仍低于佩戴矫形器前的值。压力垫的平均压力为7.09±1.77kPa(53.2±13.3mmHg),而束带的平均张力为26.8±5.2N厘米。站立位前后位Cobb角与垫压力(相关系数=0.931,p<0.05)和束带张力(相关系数=0.914,p<0.05)密切相关。束带张力和垫压力密切相关,相关系数为0.873(p<0.05)。这表明,在考虑脊柱矫形器的生物力学功能时,重点可能在于矫形器的固定紧度以及压力垫的位置和方向是否正确。因此,为了提高独立性,应在每条束带上设置标准张力,并需要定期密切监测。

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