青少年特发性脊柱侧凸患者脊柱柔韧性的影响因素

The influencing factors of curve flexibility in adolescent idiopathic scoliosis

中文关键词:  青少年特发性脊柱侧凸  脊柱柔韧性  影响因素

英文关键词:Adolescent idiopathic scoliosis  Curve flexibility  Influencing factors

中文摘要:

  【摘要】 目的：探讨青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者脊柱柔韧性的可能影响因素。方法：选取2006年12月～2008年4月在我院脊柱外科手术治疗的204例AIS患者，男性36例，女性168例，平均年龄15.0岁；平均Cobb角50.1°；平均Risser征3.4度；主弯跨度平均6.8个椎体；主弯顶椎旋转度平均2.0度。摄站立位全脊柱正侧位及仰卧左右侧屈位X线片，计算主弯柔韧性。采用相关分析研究各临床指标与主弯柔韧性的相关性。结果：女性AIS患者的脊柱柔韧性明显高于男性（P＜0.05）；胸腰弯组和腰弯组AIS患者的脊柱柔韧性显著大于胸弯组（P＜0.05），胸腰弯和腰弯组之间无显著性差异（P＞0.05）。女性AIS患者中的年龄及主弯Cobb角（站立位与侧屈位）均与脊柱柔韧性显著负相关（P＜0.05），且胸弯女性AIS患者的月经初潮至手术时间及顶椎旋转度也与脊柱柔韧性显著负相关（P＜0.05）。男性胸弯AIS患者中侧屈位主弯Cobb角、胸腰弯/腰弯组中主弯Cobb角（站立位与侧屈位）均与脊柱柔韧性显著负相关（P＜0.05）。主弯跨度及Risser征与脊柱柔韧性均无明显相关性（P＞0.05）。结论：女性AIS患者脊柱柔韧性受年龄、月经初潮至手术时间、主弯Cobb角（站立位与侧屈位）、弯型及顶椎旋转度等因素影响；男性AIS患者的脊柱侧凸柔韧性主要受主弯Cobb角及弯型影响。

英文摘要:

  【Abstract】 Objective：To assess the curve flexibility in adolescent idiopathic scoliosis（AIS） and investigate its influencing factors.Method：This study included 204 patients with AIS（36 males，168 females），selected from December 2006 to April 2008，with mean age 15.0 years old，mean Cobb angle 50.1°，mean Risser sign 3.4，mean main curve span 6.8 vertebrae and mean apical rotation 2.0°．Preoperative radiographs included a standing posteroanterior film and supine maximal voluntary side bending films of the spine.The relationships between these clinical index and curve flexibility were assessed using correlation analysis.Result：The curve flexibility was significantly higher in female AIS patients than the males（P＜0.05）.Furthermore，the patients with thoracolumbar and lumbar scoliosis had significantly better curve flexibility compare to thoracic scoliosis（P＜0.05）.However，there was no significantly difference in curve flexibility of AIS patients between thoracolumbar and lumbar AIS patients（P＞0.05）.Correlation analysis showed that Cobb angle and age were significant predictors of curve flexibility in the group of AIS girls.When menarche age and apical vertebral rotation were highly correlated with curve flexibility in AIS female patients with thoracic curve.Moreover，significant negative correlation were observed between the side bending Cobb angle in thoracic AIS boys，and the major Cobb angle measured on posteroanterior and lateral-bending radiographs in thoracolumbar and lumbar AIS boys and curve flexibility.There was no significant correlation between Risser sign，main curve span and curve flexibility.Conclusion：Cobb angle，age，menarche age，apical vertebral rotation，and curve location are useful predictors of curve flexibility in AIS girls.In addition，correlation analysis shows that Cobb angle and curve location are the only significant predictors of flexibility in AIS boys.