支具治疗青少年特发性脊柱侧凸

目的介绍青少年特发性脊柱侧凸支具治疗，并评价其临床疗效。方法22例骨骼发育未成熟的青少年特发性脊柱侧凸进行Milwaukee支具或Boston支具矫正，其中男6例，女16例；年龄10～15岁，平均13．2岁。胸腰双主弯7例，单胸弯9例，单胸腰弯或腰弯6例。Risser征0度10例，Ⅰ度5例，Ⅱ度4例，Ⅲ度3例。原发弯Cobb角20°～52°，平均32．9°，20°～35°者10例，大于35。者12例。每3—6个月定期复查，摄片，测量初次就诊及末次随诊时Cobb角、顶椎旋转度及Risser征。结果全部病例随诊3～5年，32．3％的病例出现脊柱侧凸进展，不同类型脊柱侧凸中胸腰双主弯进展率最低，Risser征越小，初步支具矫正率越大，测凸进展越高。结论不同类型脊柱侧凸中胸腰双主弯的支具治疗失败率最低，原发弯Cobb角越大，测凸进展的可能性越大。

Clinical Outcomes of Bracing in Adolescent Idiopathic Scoliosis

Objective To introduce clinical of bracing for adolescent idiopathic scoliosis, and evaluate its clinical outcomes. Methods 22 immatured skeleton patients suffered from adolescent idiopathic scoliosis with no history of prior man- agement. They were treated with Milwaukee or Boston brace,including 6 males and 16 females. The age of the patients at the time of bracing ranged from 10 to 15 years（ mean 13.2 years）. 7 patients had double major curve,9 patients had single thoracic curve, and 6 patients had either single thoracolumbar or single lumbar curve. Risser sign was 0 in 10, Ⅰ in 5,Ⅱ in 4, and Ⅲ in 3. The mean primary curve was 32.9° （ range,20° - 52° ）, including curves between 20 ° - 35° in 10 cases and exceed 35 °in 12. X -ray films were obtained at intervals of 3 to 6 months. The cobb＇s angle, the apical wertebral rotation and the Risser sign were measured at initial brace application and at the latest follow - up. Results With a follow - up of 3 to 5 years ,7 patients were judged as curve progression. Patients with double major curve were found to have the lowest percentage of curve progression. The lower the Risser sign, the higher the inntial brace correction rate mad the percentage of curve progression. Conclusion Patients with double major curve have the lowest rate of treatment failure. The amount of the cobb＇s angle, the higher the percentage of curve progression.