Wilk Bryan, Karol Lori A, Johnston Charles E, Colby Scott, Haideri Nasreen
Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA.
Spine (Phila Pa 1976). 2006 Feb 1;31(3):309-14. doi: 10.1097/01.brs.0000197168.11815.ec.
Movement analysis of spinal motion.
To compare spinal motion among females with normal spines, those with idiopathic scoliosis who had not had spinal fusion, and those who had undergone fusion for idiopathic scoliosis.
Previous reports have documented loss of spinal motion following fusion for idiopathic scoliosis in adolescents and adults. To our knowledge, comparison to control groups both with and without scoliosis that have not had spinal fusions has not been performed to date.
A total of 91 females between the ages of 15 and 28 years underwent computerized movement analysis. There were 34 fused patients, 32 unfused patients, and 25 healthy controls. The fused patients were divided into 3 groups: (1) 21 patients who had thoracic fusions that extended distally to T11, T12, or L1; (2) 6 patients with thoracic fusions ending at L2; and (3) 7 patients with thoracolumbar or lumbar fusions extending to L3 or L4. Marker triads were placed at C7-T1, T12-L1, and on the pelvis. Forward bend, extension, and left and right lateral bend were measured and divided into thoracic and lumbar motion.
There was no difference in any motion between the control and unfused groups. There was overall 25% less total spinal motion in the surgical groups compared to the unfused group. Patients who had thoracic fusions had diminished thoracic motion, especially lateral bending, whereas those who had lumbar fusions had the least lumbar motion, particularly on forward bend and lateral bend maneuvers. There was no compensatory hypermobility of the unfused segments in the surgical group.
Diminished spinal motion can be measured in patients who have had spinal fusions. Although stiffness in the operated curves should be expected, compensatory hypermobility in the unfused segments does not occur, resulting in a net loss of flexibility compared to controls.
脊柱运动的分析。
比较脊柱正常的女性、未进行脊柱融合的特发性脊柱侧凸女性以及已接受特发性脊柱侧凸融合手术的女性之间的脊柱运动情况。
既往报告已记录青少年和成人特发性脊柱侧凸融合术后脊柱运动的丧失。据我们所知，迄今为止尚未对未进行脊柱融合的脊柱侧凸和非脊柱侧凸对照组进行比较。
共91名年龄在15至28岁之间的女性接受了计算机化运动分析。其中有34名融合手术患者、32名未融合患者和25名健康对照者。融合手术患者分为3组：（1）21名胸段融合延伸至T11、T12或L1的患者；（2）6名胸段融合止于L2的患者；（3）7名胸腰段或腰段融合延伸至L3或L4的患者。在C7 - T1、T12 - L1和骨盆处放置标记三联体。测量前屈、后伸以及左右侧屈，并分为胸段和腰段运动。
对照组和未融合组之间在任何运动方面均无差异。与未融合组相比，手术组的脊柱总运动总体减少了25%。胸段融合的患者胸段运动减少，尤其是侧屈，而腰段融合的患者腰段运动最少，尤其是在前屈和侧屈动作时。手术组未融合节段没有代偿性活动过度。
脊柱融合术后患者的脊柱运动可被测量。虽然手术节段僵硬是预期的，但未融合节段不会出现代偿性活动过度，与对照组相比导致灵活性净损失。
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