Head of the Spine Group, Hospital do Servidor Público Estadual (HSPE), São Paulo, Brazil.
Member of the Spine Group, Hospital do Servidor Público Estadual (HSPE), São Paulo, Brazil.
J Back Musculoskelet Rehabil. 2021;34(5):821-828. doi: 10.3233/BMR-200320.
Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves.
A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt.
The Cobb angle averaged 51.3∘± 14.9∘. Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p= 0.003); Cobb angle thoracic distal (p= 0.001); Cobb angle lumbar (p= 0.001); kyphosis (T5-T12, p= 0.012); and kyphosis (T1-T12, p= 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery.
The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process.
特发性脊柱侧凸伴有姿势改变、步态不稳定和功能障碍。目的是验证伴有全节段（除最上段外）1 型截骨和椎旁 2 型截骨的直接椎体旋转（DVR）的青少年特发性脊柱侧凸（AIS）术前和术后的影像学参数（冠状位和矢状位）。
采用前瞻性研究设计，评估并比较了 41 例 AIS 患者术前和术后的情况。脊柱 X 线检查（Cobb 角）证实存在脊柱侧凸。测量了 8 项影像学参数：Cobb 角（胸近端和胸远端）、节段性后凸、总后凸、腰椎前凸、骨盆入射角、骶骨倾斜度和骨盆倾斜角。
Cobb 角平均为 51.3∘± 14.9∘。术后，以下脊柱测量参数显著降低：胸近端 Cobb 角（p= 0.003）；胸远端 Cobb 角（p= 0.001）；腰椎 Cobb 角（p= 0.001）；后凸（T5-T12，p= 0.012）；后凸（T1-T12，p= 0.002）。这些降低表明手术矫正对减少 Cobb 角和改善胸椎后凸有明显的效果。术后腰椎前凸、骨盆入射角、骶骨倾斜度和骨盆倾斜角的测量值与术前无显著差异。
DVR 手术技术在 AIS 中被证明在冠状位和矢状位参数方面对 Cobb 角和胸椎后凸有效，有利于康复过程。
