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严重特发性脊柱侧凸(Cobb 角≥90°)矫正率的预测因素:128 例患者分析。

Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients.

机构信息

Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.

Department of Orthopaedic Surgery, Hamamatsu University, School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu-shi, Shizuoka, Japan.

出版信息

Eur Spine J. 2021 Mar;30(3):653-660. doi: 10.1007/s00586-020-06701-3. Epub 2021 Jan 23.

Abstract

PURPOSE

Knowledge on the factors affecting the correction rate (CR) aids in the surgical planning among severe idiopathic scoliosis (IS) patients. This study aimed to investigate the independent factors affecting CR among patients with severe IS (Cobb angle ≥ 90°) who underwent single-staged posterior spinal fusion (PSF).

METHODS

We retrospectively reviewed 128 severe IS patients who underwent single-staged PSF. Factors including age, height, weight, body mass index, Risser sign, Lenke subtypes, preoperative major Cobb angle, side bending major Cobb angle, side bending flexibility (SBF), motion segments of the major curve, AR curve, number of levels fused, screw density, operative time and postoperative major Cobb angle were analysed using linear regression analysis.

RESULTS

The mean age was 15.5 ± 4.5 years with mean Risser sign of 3.1 ± 1.6. The mean preoperative Cobb, SBF, postoperative Cobb and CR were 102.8 ± 12.3°, 37.5 ± 13.7%, 44.4 ± 13.5° and 57.2 ± 10.8%, respectively. From stepwise multiple linear regression analysis, SBF, Risser sign and AR curve were the independent predictive factors for CR, with R value of 0.345 (p < 0.001). CR can be predicted using the formula: 47.21 + (0.34 × SBF)-(1.47 × Risser sign) + (3.69 × AR), where AR = 1 and non-AR = 0.

CONCLUSION

The flexibility of the major curve, Risser sign and AR curve were the most important predictors for CR in a single-staged PSF among patients with severe IS.

摘要

目的

了解影响矫正率(CR)的因素有助于为严重特发性脊柱侧凸(IS)患者制定手术计划。本研究旨在探讨单阶段后路脊柱融合术(PSF)治疗严重 IS(Cobb 角≥90°)患者的独立影响 CR 的因素。

方法

回顾性分析 128 例单阶段 PSF 治疗的严重 IS 患者。使用线性回归分析年龄、身高、体重、体重指数、Risser 征、Lenke 亚型、术前主 Cobb 角、侧凸主 Cobb 角、侧凸柔韧性(SBF)、主弯活动节段、AR 弯、融合节段数、螺钉密度、手术时间和术后主 Cobb 角等因素。

结果

平均年龄为 15.5±4.5 岁,平均 Risser 征为 3.1±1.6。术前 Cobb、SBF、术后 Cobb 和 CR 分别为 102.8±12.3°、37.5±13.7%、44.4±13.5°和 57.2±10.8%。逐步多元线性回归分析显示,SBF、Risser 征和 AR 弯是 CR 的独立预测因素,R 值为 0.345(p<0.001)。CR 可以通过以下公式预测:47.21+(0.34×SBF)-(1.47×Risser 征)+(3.69×AR),其中 AR=1 表示 AR 弯,AR=0 表示非 AR 弯。

结论

单阶段 PSF 治疗严重 IS 患者时,主弯柔韧性、Risser 征和 AR 弯是 CR 的最重要预测因素。

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