Zaborowska-Sapeta Katarzyna, Giżewski Tomasz, Binkiewicz-Glińska Anna, Kamelska-Sadowska Anna M, Kowalski Ireneusz M
Department of Rehabilitation, University of Warmia and Mazury, Olsztyn, Poland.
Department of Material Science and Metallurgy, University of Cambridge, Cambridge, United Kingdom.
Acta Orthop Traumatol Turc. 2019 Jan;53(1):61-67. doi: 10.1016/j.aott.2018.10.001. Epub 2018 Nov 17.
The aim of the study was to evaluate the loss of truncal rotation over 54 hours after removing Chêneau brace.
The studied groups consisted of 39 girls aged 10-18 years old, diagnosed with adolescent idiopathic scoliosis (AIS) and treated with Chêneau brace (CAST) and 20 AIS girls aged 10-18 years old, not treated with bracing. Posterior-anterior radiographs were obtained from the clinical assessment of all subjects and were subsequently used to determine Cobb angles. The measurements of the angle of trunk rotation (ATR) were taken with the Scoliometer® and back-contour device during Adams forward bending test by the two evaluators. The changes in ATRs during 54 hours of observation were performed after the brace had been taken off (0, 2, 24, 30, 48 and 54 hours after debracing). This was described using V variable, defined as the change in the absolute Scoliometer® readings in the time intervals against the time interval Δt between the measurements. During back-contour assessment the differential factor (k) has been used for the digital analysis. The changes in k over 54 hours of observation were expressed as V factor, defined as the difference in the absolute value of the amplitude differential factor (k) in the time intervals against the time interval Δt between the measurements.
The highest changes were observed in the thoracic as well as in lumbar spine in patients with Cobb angle ≥30°, axial rotation of the apical vertebrae within 5-15°, Risser sign 0-2. The biggest change in the trunk rotation after Chêneau brace had been taken off was noted within the first two hours of observation.
The patients should be advised to take the brace off for a minimum of two hours before the scheduled x-ray, to allow full relaxation of the trunk in order to obtain reliable radiological images of the deformation.
Level III Therapeutic study.
本研究旨在评估去除雪尼尔支具后54小时内躯干旋转的丢失情况。
研究组包括39名年龄在10 - 18岁、诊断为青少年特发性脊柱侧凸（AIS）且接受雪尼尔支具（CAST）治疗的女孩，以及20名年龄在10 - 18岁、未接受支具治疗的AIS女孩。所有受试者均通过临床评估获得前后位X线片，随后用于确定Cobb角。在亚当斯前屈试验中，由两名评估者使用脊柱侧凸测量仪®和背部轮廓装置测量躯干旋转角度（ATR）。在取下支具后（去除支具后0、2、24、30、48和54小时）进行54小时观察期内ATR的变化测量。这用V变量来描述，V变量定义为在各时间间隔内脊柱侧凸测量仪®读数绝对值的变化相对于测量之间的时间间隔Δt。在背部轮廓评估期间，使用微分因子（k）进行数字分析。54小时观察期内k的变化用V因子表示，V因子定义为在各时间间隔内振幅微分因子（k）绝对值的差异相对于测量之间的时间间隔Δt。
在Cobb角≥30°、顶椎轴向旋转在5 - 15°、Risser征为0 - 2的患者中，胸椎和腰椎的变化最为明显。取下雪尼尔支具后，躯干旋转的最大变化在观察的前两小时内被记录到。
应建议患者在预定的X线检查前至少两小时取下支具，以使躯干充分放松，从而获得可靠的畸形放射学图像。
三级治疗研究。
