论文部分内容阅读
目的:探讨Lenke 3型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患儿脊柱后路矫形术后身高增长(ΔSH)的相关影响因素。方法:选取2014年1月~2016年6月于我院行脊柱后路矫形手术的女性Lenke 3型AIS患儿90例,年龄15.0±2.6岁。于站立位全脊柱正侧位X线片上测量术前、术后的主弯侧凸Cobb角1(最大侧凸Cobb角)、侧凸Cobb角2(次之侧凸Cobb角)、脊柱高度(spinal height,SH)、胸椎后凸角(thoracic kyphosis,TK)及腰椎前凸角(lumbar lordosis,LL)。应用Pearson相关分析ΔSH与其他参数之间的相关性,应用线性回归探讨ΔSH的相关影响因素。结果:ΔSH为2.9±1.0cm。Pearson相关性分析示ΔSH与术前的侧凸Cobb角1(P=0.000)、侧凸Cobb角2(P=0.000)及TK(P=0.023)均呈显著相关性,与术后的侧凸Cobb角1(P=0.000)、侧凸Cobb角2(P=0.000)、LL(P=0.025)、侧凸Cobb角1变化(P=0.000)、侧凸Cobb角2变化(P=0.000)及TK变化(P=0.032)均呈显著相关性。线性回归分析示ΔSH与侧凸Cobb角1变化(P=0.017)、侧凸Cobb角2变化(P=0.001)均呈显著线性相关(R~2=0.333);另外,ΔSH与术前侧凸Cobb角1(P=0.006)、侧凸Cobb角2(P=0.007)、术前TK(P=0.038)亦呈显著线性相关(R~2=0.595)。结论:Lenke 3型AIS患儿脊柱后路矫形术后身高增长的相关影响因素包括术前、术后的主弯侧凸Cobb角、术前TK及其术后变化值。主弯Cobb角矫正是Lenke 3型AIS术后身高增加的最主要影响因素。Lenke 3型AIS患儿的术前侧凸Cobb角及术前TK可以较好地预测患儿术后身高恢复情况。
Objective: To investigate the related factors of height growth (ΔSH) in children with Lenke type 3 adolescent idiopathic scoliosis (AIS) after posterior spinal correction. Methods: Ninety 90 children with Lenke type 3 AIS who underwent orthopedic spine surgery in our hospital from January 2014 to June 2016 were selected, aged 15.0 ± 2.6 years. The maxillary Cobb angle 1 (maximal scoliosis Cobb angle), Scoliosis Cobb angle 2 (Cobb angle secondarily), and Spine height spinal height, SH, thoracic kyphosis (TK) and lumbar lordosis (LL). Pearson correlation analysis was used to analyze the correlation between ΔSH and other parameters, and linear regression was used to explore the related factors of ΔSH. Results: ΔSH was 2.9 ± 1.0 cm. Pearson correlation analysis showed that ΔSH was significantly correlated with preoperative Cobb angle 1 (P = 0.000), Cobb angle 2 (P = 0.000) and TK (P = 0.023), and postoperative scoliosis Cobb angle 1 (P = 0.000), Cobb angle 2 (P = 0.000), LL (P = 0.025), Cobb angle 1 (P = 0.000) and Cobb angle 2 (P = 0.000) And TK changes (P = 0.032) were significantly correlated. Linear regression analysis showed a significant linear correlation between ΔSH and Cobb angle 1 (P = 0.017) and Cobb angle 2 (P = 0.001) (R ~ 2 = 0.333). In addition, Cobb angle 1 (P = 0.006), scoliosis Cobb angle 2 (P = 0.007) and preoperative TK (P = 0.038) also showed a significant linear correlation (R ~ 2 = 0.595). CONCLUSION: The related factors of height growth after posterior spine posterior spinal surgery in children with Lenke type 3 AIS include the preoperative and postoperative Cobb angle, the preoperative TK and its postoperative changes. Main Cobb angle correction is the most important factor for the height increase of Lenke type 3 AIS. Preoperative keratoconus Cobb angle and preoperative TK in children with Lenke type 3 AIS can better predict postoperative height recovery in children.