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评价 Cheneau 支具治疗伴有顶椎旋转的胸腰段青少年特发性脊柱侧凸的疗效。

Evaluation of Chêneau brace in the treatment of thoracic and lumbar adolescent idiopathic scoliosis with apical vertebral rotation.

机构信息

Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.

The Second Clinical Medical College, Lanzhou Unversity, Lanzhou, Gansu, China.

出版信息

J Back Musculoskelet Rehabil. 2023;36(6):1345-1354. doi: 10.3233/BMR-220363.

Abstract

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is a common structural disorder of the spine in adolescents, often associated with structural deformities in both coronal and axial positions. Apical vertex rotation (AVR) is one of the main indicators of axial deformity in patients with scoliosis. Currently, there are few studies on the impact of AVR in the treatment of AIS.

OBJECTIVE

This study examined the influence of different AVR on AIS after brace treatment.

METHODS

Data were collected from 106 AIS participants aged 11-16 years from the orthopedic outpatient clinic of the Second Hospital of Lanzhou University. Two orthopaedic professionals measured the Cobb angle, AVR and spinal mid-line offset before and after brace treatment, and descriptive and linear correlation analyses were used to determine the correlation between AVR and AIS measured parameters.

RESULTS

(1) In AIS volunteers with the same AVR, the treatment effect of AIS with lumbar predominant curvature was higher than that of AIS with thoracic predominant curvature. The treatment effect tended to decrease with increasing AVR. (2) Spinal mid-line deviation was associated with AVR. For patients with AIS with I and II degrees of AVR, the treatment effect of spinal mid-line offset after bracing is better. For AIS patients with AVR III degrees and above, the degree of correction of spinal mid-line offset decreases with the continuous correction of Cobb angle.

CONCLUSIONS

The efficacy of AIS was found to be related to the severity of AVR. The efficacy of AIS with predominantly lumbar curvature was significantly higher than that of AIS with predominantly thoracic curvature. The efficacy of treatment of mid-line spinal deviation also decreased with increasing AVR.

摘要

背景

青少年特发性脊柱侧凸(AIS)是青少年中常见的脊柱结构性疾病,常伴有冠状位和轴位的结构性畸形。顶椎旋转(AVR)是脊柱侧凸患者轴向畸形的主要指标之一。目前,关于 AVR 对 AIS 治疗影响的研究较少。

目的

本研究探讨了不同 AVR 对支具治疗后 AIS 的影响。

方法

收集兰州大学第二医院骨科门诊 106 例 11-16 岁 AIS 患者的数据。两名骨科专业人员在支具治疗前后测量 Cobb 角、AVR 和脊柱中线偏移,采用描述性和线性相关分析确定 AVR 与 AIS 测量参数之间的相关性。

结果

(1)在 AVR 相同的 AIS 志愿者中,腰椎为主弯 AIS 的治疗效果高于胸弯为主弯 AIS。治疗效果随 AVR 的增加而降低。(2)脊柱中线偏移与 AVR 相关。对于 AVR I 度和 II 度的 AIS 患者,支具治疗后脊柱中线偏移的治疗效果更好。对于 AVR III 度及以上的 AIS 患者,随着 Cobb 角的不断矫正,脊柱中线偏移的矫正程度降低。

结论

AIS 的疗效与 AVR 的严重程度有关。以腰椎为主弯的 AIS 疗效明显高于以胸椎为主弯的 AIS。治疗脊柱中线偏离的疗效也随 AVR 的增加而降低。

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