摘要
目的:研究Lenke5、Lenke6型青少年特发性脊柱侧凸患者(adolescent idiopathic scoliosis,AIS)接受后路矫形术后临床美学的改善,探讨临床美学改善程度与影像学改善程度的相关性。方法:研究对象为28例以腰弯/胸腰弯为主弯的AIS患者,其中Lenke5型患者12例,Lenke6型患者16例。所有患者术前、术后均摄站立位全脊柱正侧位X线片,在X线片上测量主弯Cobb角及顶椎偏移(apical vertebral translation,AVT),同时在照片上测量腰线高度指数(waistline height index,WLHI)、腰线深度指数(waistline depth index,WLDI)、腰线面积指数(waistline area index,WLAI)、腰部面积指数(waist area index,WAI)4项美学指标。美学指标测量的可重复性采用Pearson相关系数进行统计分析;术后影像学及美学改善情况采用配对t检验的方法进行比较分析;同时,对影像学改善程度及美学改善程度进行相关分析。结果:WLHI、WLDI、WLAI、WAI重复测量的相关系数分别为0.99、0.91、0.91、0.92,全部达到统计学上显著相关。AIS患者在接受后路矫形术后Cobb角及AVT都得到了明显的矫正,同时各项美学指标也得到了显著改善。Cobb角及AVT的改善程度(ΔCobb、ΔAVT)与各项美学指标的改善程度(ΔWLHI、ΔWLDI、ΔWLAI、ΔWAI)呈正相关;但是除了顶椎偏移的改善程度(ΔAVT)与腰线深度指数的改善程度(ΔWLDI)的相关系数超过0.8,其余的相关系数只在0.43～0.73之间。结论:Lenke5、Lenke6型AIS患者在接受后路矫形术后,影像学及临床美学外观都得到了显著的改善,但影像学指标的改善程度只能部分反映美学指标的改善。
Objective：To investigate the improvement of physical appearance in thoraclumbar/lumbar adoles-cent idiopathic scoliosis （AIS） patients who underwent posterior correction,and to explore the correlation be-tween the improvement of physical appearance and radiological index.Method：Twenty eight AIS patients with lumbar/thoracolumbar curve as the main curve were recruited for this study,including 12 lenke 5 curve type AIS patients and 16 lenke 6 curve type AIS patients.Cobb angles and apical vertebral translation （AVT） were measured in the standing posteroanterior radiographs before and after surgery.Waistline height index （WLHI）,waistline depth index （WLDI）,waistline area index（WLAI） and waist area index（WAI） were mea-sured from the standing photographs.Pearson′s rank correlation coefficient was used to assess measurement re-liability for the cosmetic indexes,t test was used for the comparison of cosmetic and radiological indexes be-fore and after surgery,the correlation analysis were performed between the improvement of cosmetic indexes and radiological changes.Result：The Pearson correlation coefficients of repeat measurements for WLHI,WLDI, WLAI,WAI were 0.99,0.91,0.91,0.92,and all reached statistically significant.The cosmetic indexes improved along with the improvement of Cobb angle and AVT after surgery.Cobb,AVT correlated significantly with WLHI,WLDI,WLAI,WAI,but besides AVT and WLDI,all the other correlation coefficients were less than 0.8.Conclusion：After posterior spine surgery,the cosmetic indeces improved along with the improvement of radiological indeces in thoraclumbar/lumbar AIS patients,but radiological improvement could only partially reflecte cosmetic improvement.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2010年第10期825-829,共5页
Chinese Journal of Spine and Spinal Cord
