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未经治疗的轻度胸椎Scheuermann驼背的进展——平均随访46年后的影像学和功能评估

Progression of untreated mild thoracic Scheuermann's kyphosis - Radiographic and functional assessment after mean follow-up of 46 years.

作者信息

Ristolainen Leena, Kettunen Jyrki A, Kujala Urho M, Heinonen Ari, Schlenzka Dietrich

机构信息

Orton Orthopaedic Hospital and Orton Research Institute, Orton Foundation, Tenholantie 10, PL 29, 00281, Helsinki, Finland.

Arcada, University of Applied Sciences, Jan-Magnus Janssonin aukio 1, 00560, Helsinki, Finland.

出版信息

J Orthop Sci. 2017 Jul;22(4):652-657. doi: 10.1016/j.jos.2017.03.009. Epub 2017 Apr 15.

Abstract

BACKGROUND

There is no data available on the radiographic development of the Scheuermann's deformity. Our purpose was to investigate radiographic deformity progression and the relation between kyphosis progression and clinical outcome in patients with untreated Scheuermann's kyphosis.

METHODS

Thoracic kyphosis (Th4-Th12) was measured from standing lateral radiographs in 19 patients at baseline and after mean 46-year follow-up. Mean age at baseline was 19.2 and at follow-up 64.7 years. At follow-up, height, weight, hand grip strength, and hamstring tightness were measured, and sit-to-stand and walking tests were performed. Additionally general health and quality of life questionnaires were administered.

RESULTS

The mean thoracic kyphosis increased from 46° (range 25°-78°) at baseline to 60° (34°-82°) (p < 0.001) at follow-up. Mean of the vertebrae wedge increased from 8.8° to 9.9° (p = 0.046). There was no correlation between extent of kyphosis progression and function at follow-up.

CONCLUSIONS

Among patients with Scheuermann's disease the degree of radiographic deformity progressed slightly during long-term follow-up. Progression did not predict symptoms.

摘要

背景

关于休曼氏脊柱后凸畸形的影像学发展尚无可用数据。我们的目的是研究未经治疗的休曼氏脊柱后凸患者的影像学畸形进展以及后凸进展与临床结局之间的关系。

方法

对19例患者在基线时及平均46年随访后,通过站立位侧位X线片测量胸段后凸(Th4-Th12)。基线时平均年龄为19.2岁,随访时为64.7岁。随访时,测量身高、体重、握力和绳肌紧张度,并进行坐立和行走测试。此外,还进行了一般健康和生活质量问卷调查。

结果

胸段后凸平均度数从基线时的46°(范围25°-78°)增加到随访时的60°(34°-82°)(p < 0.001)。椎体楔形变平均度数从8.8°增加到9.9°(p = 0.046)。后凸进展程度与随访时的功能之间无相关性。

结论

在休曼氏病患者中,长期随访期间影像学畸形程度略有进展。进展并不能预测症状。

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