摘要
目的:观察支具治疗女性青少年特发性脊柱侧凸的畸形变化情况并分析侧凸畸形进展的危险因素。方法:对65例接受支具治疗的女性青少年特发性脊柱侧凸患者进行随访。在随访期间连续测量记录患者的Cobb角、侧凸类型、月经初潮与否、坐高、站高、Risser分级、顶椎旋转度等。分析初诊时和末次随访时侧凸变化情况,并从上述多项参数中筛选引起侧凸加重的危险因素。结果:65例获得随访,时间12～60个月,平均24.1个月。初诊年龄10～16岁,平均13.7岁。末次随访时17例(26.15%)患者侧凸进展超过5°,初诊时原发弯Cobb角>35°,顶椎旋转度≥Ⅲ度的患者,侧凸明显进展的百分率较高(P<0.05)。通过Logistic逐步回归分析,发现初诊时原发弯Cobb角>35°,顶椎旋转度≥Ⅲ度,年身高增长>30mm的患者,是侧凸进展到5°以上的危险因素。结论:初诊时原发弯Cobb角值,顶椎旋转度及身高增长速度是预测女性青少年特发性脊柱侧凸进展的重要因素,借助Risser分级预测侧凸进展并不可靠,初始原发弯Cobb角>35°、顶椎旋转度≥Ⅲ度、年身高增长>30mm的患者,侧凸进展的危险性较高。
Objective ：To observe deformed change of adolescent idiopathic scoliosis （AIS）in female after treatment with brace and analyze risk factors for curve progress. Methods：Sixty-five females with AIS were followed up after treatment with brace. Cobb＇s angle, curve patterns, menarche status, sitting height, standing height, Risser grade, apical vertebral rotation, etc were consecutively measured during follow-up. Curve change between the first visit and final follow-up was analyzed. Results： All the patients were followed up 12 -60 months（ mean,24. 1 months）. The average age of patients was 13.7 years, ranging from 10 to 16 years in the first visit. At the time of final follow-up,curve progress more than 5 degrees occured in 17 cases （26. 15% ）. The percentage of curve progress was significantly higher in the cases with apical vertebral rotation greater than or equal to grade Ⅲ and Cobb＇s angle more than 35 degrees at the first visit（ P 〈 0. 05 ）. After performing a logistic regression analysis,initial Cobb＇s angle more than 35 degrees, apical vertebral rotation greater than or equal to grade Ⅲ, and standing height increasing more than 30 mm in one year were found to be prognostic for curve progress more than 5 degrees. Conclusion：Initial Cobb＇s angle more than 35 degrees, apical vertebral rotation greater than or equal to grade Ⅲ, and standing height increasing more than 30 mm in one year are important prognostic factors for curve progress in female with AIS. Risser grade is an unreliable parameter for predicting the progress of scoliosis.
出处
《中国骨伤》
CAS
2007年第4期237-240,共4页
China Journal of Orthopaedics and Traumatology
关键词
脊柱侧凸
青少年
矫形外科
矫正装置
Scoliosis
Adolescent
Orthopedic surgery
Orthotic devices
