Lenke 3型青少年特发性脊柱侧凸后路矫形术后身高增长的相关影响因素分析

Associated factors with height gain in Lenke 3 adolescent idiopathic scoliosis undergoing posterior spinal correction surgery

中文关键词:  青少年特发性脊柱侧凸  后路矫形  身高矫正  相关因素

英文关键词:Adolescent idiopathic scoliosis  Posterior spinal correction surgery  Height gain  Correlated factors

中文摘要:

  【摘要】 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（R2=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（R2=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。

英文摘要:

  【Abstracts】 Objectives: To investigate the factors associated with height gain after posterior spinal correction surgery in Lenke 3 adolescent idiopathic scoliosis(AIS). Methods: A total of 90 Lenke 3 AIS patients undergoing posterior spinal correction surgery from January 2014 to June 2016 was retrospectively reviewed. The average age was 15.0±2.6 years. The pre-op and post-op Cobb angles of structural Cobb angle 1(main curve), Cobb angle 2(second main curve), spinal height(SH), thoracic kyphosis(TK) and lumbar lordosis(LL) were measured on standing whole spine X-rays. The correlations between ΔSH(post-op SH minus pre-op SH) and other parameters were assessed by using Pearson coefficients while the linear regression analysis was used for the predictive model of ΔSH. Results: The average ΔSH was 2.9±1.0cm. The Pearson correlation analysis showed that the ΔSH was significantly correlated with pre-op Cobb angle 1(P=0.000) and Cobb angle 2(P=0.000) of structural main curves and TK(P=0.023). The ΔSH was also significantly correlated with post-op Cobb angle 1(P=0.000), Cobb angle 2(P=0.000), LL(P=0.025), change in Cobb angle 1(P=0.000), change in Cobb angle 2(P=0.000), and change in TK(P=0.032). The linear regression model revealed that change in Cobb angle 1(P=0.017) and change in Cobb angle 2(0.001) were predictive for ΔSH(R2=0.333). The linear regression model also showed that the pre-op Cobb angle 1(P=0.006), Cobb angle 2(P=0.007) and TK(P=0.038) were the correlated factors for ΔSH(R2=0.595). Conclusions: The correlated factors of ΔSH include pre-op and post-op Cobb angles of main curves, pre-op TK, change in TK in Lenke 3 AIS. The correction of main curves is the most important correlated factor for ΔSH. The pre-op Cobb angle and TK are predictive factors for change in height gain in Lenke 3 AIS.