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[目的]通过影像学测量脊柱高度和胸廓容积变化,评估生长棒技术治疗先天性脊柱侧凸对胸廓发育的影响。[方法]分析2010年7月~2016年7月本院23例应用生长棒技术治疗的先天性脊柱侧凸患儿的完整资料,测量术前、初次及各次撑开术后和末次随访时脊柱全长正侧位X线片脊柱和胸廓发育相关参数指标,包括主胸弯Cobb角、T_1~T_(12)高度、胸椎后凸角度、胸廓前后径和矢状纵径、胸廓最大宽度、坎贝尔空间供肺比值,并进行统计学分析。[结果]初次及各次撑开术后和末次随访时,主胸弯Cobb角、TK、T_1~T_(12)高度、胸廓最大宽度、胸廓前后径和矢状纵径以及SAL均较术前差异有统计学意义(P<0.05);术前到末次随访主胸弯Cobb角变化值与T_1~T_(12)高度(r=0.584,P<0.05)、胸廓矢状高度(r=.0594,P<0.05)及SAL的变化值间(r=0.693,P<0.05)呈正相关;随撑开次数增加,各项胸廓发育参数变化曲线先显著增加后逐渐趋于平缓。[结论]利用生长棒技术治疗先天性脊柱侧凸,不仅能够矫正脊柱畸形、保留脊柱生长潜能,还可以调整左右胸廓的高度差和不对称性,增加胸廓容积容量,但随着撑开次数增加,这种效应逐渐趋于减弱。
[Objective] To evaluate the effect of growth bar technique on thoracic development by measuring the height of the spine and the change of thoracic volume. [Methods] From July 2010 to July 2016, 23 cases of congenital scoliosis treated with growth bar technique in our hospital from January 2010 to July 2016 were analyzed retrospectively. Preoperative, primary and postoperative propping up and final follow-up were measured. Spine length X-ray posterior spine and thoracic development related parameters, including the main chest Cobb angle, T_1 ~ T_ (12) height, thoracic kyphotic angle, thoracic anteroposterior diameter and sagittal longitudinal diameter, the maximum width of the thorax, Campbell space for pulmonary ratio, and statistical analysis. [Results] The Cobb angle, TK, T_1 ~ T_ (12) height, maximum thoracic width, thoracic anteroposterior diameter and sagittal length, and SAL of the primary thoracotomy were significantly higher than those of the preoperative (P <0.05). The changes of Cobb angle between the preoperative and the final follow-up were significantly different from those of the T_1-T 12 height (r = 0.584, P <0.05) , P <0.05) and the change of SAL (r = 0.693, P <0.05). With the increase of the number of distraction, the curves of various thoracic development parameters gradually increased and gradually became gentle. [Conclusion] Using growth-stick technique to treat congenital scoliosis can not only correct the spinal deformity and retain the growth potential of the spine, but also adjust the height difference and asymmetry of the left and right thorax to increase the volume capacity of the thoracic cavity. However, as the number of distraction increases , This effect gradually tends to weaken.