色努(Chêneau)支具在青少年特发性脊柱侧凸的应用

被引:16
作者
程剑洋
王策
马君
周许辉
贾连顺
机构
[1] 第二军医大学附属长征医院骨科
关键词
色努支具; 青少年特发型脊柱侧凸; 胸廓; 肩关节; 骨盆;
D O I
暂无
中图分类号
R726.8 [小儿骨科学];
学科分类号
100202 [儿科学];
摘要
[目的]研究色努支具对青少年特发性脊柱侧凸的治疗效果及不良影响。[方法]回顾性研究本院2013~2015年接诊的使用色努支具的青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者68例,其中女64例,男4例;平均年龄(12.9±1.4)岁,平均治疗327 d。根据支具治疗前、穿戴支具时及随访时所拍摄的脊柱全长X线片,测量患者胸廓横径(thoracic transverse diameter,TTD)、胸廓前后径(thoracic antero-posterior diameter,APD)、两侧肩关节高度(radiographic shoulder height,RSH)和冠状位骨盆倾斜角(pelvic obliquity angle,PO)。对收集数据进行分析整理,探讨色努支具的治疗效果以及使用支具对患者胸廓发育、双肩平衡及骨盆倾斜的影响。[结果]支具治疗前平均Cobb角(29.4±5.2)°,治疗后减少为(23.4±6.3)°(P<0.05)。治疗前胸廓横径(TTD)为(229.4±14.4)mm,支具穿戴时下降至(219.9±16.6)mm(P<0.05)。治疗后TTD为(228.6±15.7)mm,明显低于TTD预测值(234.2±14.7)mm(P<0.05)。治疗前胸廓前后径(APD)为(81.4±14)mm,支具穿戴时为(79.1±13.5)mm(P<0.05)。支具治疗后为(80.7±13.3)mm,同样明显小于预测值(82.4±13.9)mm(P<0.05)。支具治疗前双侧肩关节高度差(RSH)为(7±7.4)mm,治疗后RSH为(8.4±7.7)mm(P>0.05)。支具治疗前冠状位骨盆倾斜角(PO)为(1.5±2)°,治疗后为(1.4±1.8)°(P>0.05)。[结论]色努支具能够有效控制轻度AIS患者的侧凸进展,但会限制胸廓的发育,并影响双肩平衡的风险,尚未发现色努支具加重骨盆倾斜的证据。
引用
收藏
页码:794 / 799
页数:6
相关论文
共 19 条
[1]
基于MSCT三维成像测量中国3~12岁儿童胸廓正常值.[D].谢春艳.中南大学.2013, 05
[2]
Chêneau brace for adolescent idiopathic scoliosis: long-term results. Can it prevent surgery?.[J].S. Giorgi;A. Piazzolla;S. Tafuri;C. Borracci;A. Martucci;G. Giorgi.European Spine Journal.2013, 6
[3]
Bracing in adolescent idiopathic scoliosis [J].
Schlenzka, Dietrich ;
Yrjonen, Timo .
JOURNAL OF CHILDRENS ORTHOPAEDICS, 2013, 7 (01) :51-55
[4]
European Braces Widely Used for Conservative Scoliosis Treatment.[J].Carl-Eric Aubin;Ian A.F. Stokes;Hubert Labelle;Alain Moreau;Theodoros B. Grivas;Angelos Kaspiris.Studies in Health Technology and Informatics.2010,
[5]
Interobserver and Intraobserver Reliability of Cobb Angle Measurement: Endplate Versus Pedicle as Bony Landmarks for Measurement: A Statistical Analysis [J].
Mehta, Satyen S. ;
Modi, Hitesh N. ;
Srinivasalu, Santhana ;
Chen, Ting ;
Suh, Seung Woo ;
Yang, Jae-Hyuk ;
Song, Hae Ryong .
JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2009, 29 (07) :749-754
[6]
Adolescent idiopathic scoliosis [J].
Weinstein, Stuart L. ;
Dolan, Lori A. ;
Cheng, Jack C. Y. ;
Danielsson, Aina ;
Morcuende, Jose A. .
LANCET, 2008, 371 (9623) :1527-1537
[7]
The Feasibility; Safety; and Utility of Vertebral Wedge Osteotomies for the Fusionless Treatment of Paralytic Scoliosis.[J].James T. Guille;Randal R. Betz;Rohinton K. Balsara;M. J. Mulcahey;Linda P. D’Andrea;David H. Clements.Spine.2003, 20S
[8]
Correlation of radiographic, clinical, and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis [J].
Kuklo, TR ;
Lenke, LG ;
Graham, EJ ;
Won, DS ;
Sweet, FA ;
Blanke, KM ;
Bridwell, KH .
SPINE, 2002, 27 (18) :2013-2020
[9]
Factors that influence outcome in bracing large curves in patients with adolescent idiopathic scoliosis [J].
Katz, DE ;
Durrani, AA .
SPINE, 2001, 26 (21) :2354-2361
[10]
Spontaneous proximal thoracic curve correction after isolated fusion of the main thoracic curve in adolescent idiopathic scoliosis [J].
Kuklo, TR ;
Lenke, LG ;
Won, DS ;
Graham, EJ ;
Sweet, FA ;
Betz, RR ;
Bridwell, KH ;
Blanke, KM .
SPINE, 2001, 26 (18) :1966-1975