脊柱侧凸畸形支点侧屈位数字X线摄片对矫正预测评估的价值

目的:通过青少年特发性脊柱侧凸的4种术前数字X线摄影,分析适宜的摄影体位及影像,评估临床脊柱矫形的预测矫正数据。方法:对42例特发性脊柱侧凸患者的53个结构性弯曲行术前脊柱站立正位、仰卧牵引正位、仰卧侧屈正位及支点侧屈正位数字X线摄影,比较摄影特点计算校正率,并与术后站立位影像对比。测量所有Cobb角并进行统计学评价。结果:术前胸弯组和腰弯组中,仰卧牵引正位平均Cobb角分别为(43±2)°和(38±2)°,支点侧屈正位平均Cobb角分别为(35±1)°和(19±1)°,术后的Cobb角分别为(32±1)°和(18±1)°;仰卧侧屈正位平均Cobb角分别为(41±2)°和(33±2)°,支点侧屈正位Cobb角分别为(29±1)°和(12±1)°,术后Cobb角分别为(27±1)°和(12±1)°。术前及术后Cobb角之间比较:支点侧屈正位无显著性差异,而仰卧牵引正位和仰卧侧屈正位有显著性差异,(P<0.05)。支点侧屈正位校正度与校正率均大于仰卧牵引正位及仰卧侧屈正位。结论:站立正位和支点侧屈正位可保持同一状态下重复性的摄影姿势,能主动配合且易标准化。支点侧屈正位能真实反映侧凸的僵硬程度及柔韧度,较准确地预测脊柱侧凸矫形的校正度。

Evaluation of Predictive Rectification Data of Scoliosis Abnormity by Fulcrum Bending Radiograph

Objective: To analyze the eligible photograph body position and image and to evaluate the predictive rectification data,by four preoperative figure Xray imaging of adolescent idiopathic scoliosis(AIS).Methods: A total of 42 cases of AIS with 53 structural curves were studied by preoperative radiographs of standing,supine-bending and fulcrum-bending,which were compared with standing radiographs after surgery.The Cobb angles were measured and compared.Results: In thoracic and lumbar group,the mean Cobb angles of supine draft position were(43±2)°and(38±2)°,supine side-bending angles were(35±1)°and(19±1)°,and post-operation angles were(32±1)° and(18±1)°,respectively.The mean Cobb angles of supine lateral flexion position in thoracic and lumbar group were(41±2)°and(33±2)°,foothold side-bending position angles were(29±1)° and(12±1)°,fulcrum bending angles were (27±1)° and(12±1)° respectively.Comparing with the Cobb angles before operation,the foothold side-bending position had no significant difference,while the supine draft position and supine lateral flexion position had significant difference after operation.The correct rate of foothold side-bending position was higher than supine draft and supine lateral flexion position.Conclusion: Standing and foothold lateral flexion position can maintain reproducibility photograph posture of same condition,could be easy for normalization,and reflects the stiffness degree and tenacity of side-convex,which is helpful to anticipate the correct degree of scoliosis.