| 杨宏浩,海涌,周立金,等.特发性脊柱侧凸共平面技术的初步临床应用及文献回顾.骨科,2023,14(2): 111-116. |
| 特发性脊柱侧凸共平面技术的初步临床应用及文献回顾 |
| Preliminary Application of Vertebral Coplanar Alignment in Idiopathic Scoliosis and Literature Review |
| 投稿时间：2023-01-08 |
| DOI：DOI：10.3969/j.issn.1674-8573.2023.02.005 |
| 中文关键词: 特发性脊柱侧凸 共平面技术 椎体去旋转 胸椎后凸 矢状面序列 |
| 英文关键词: Idiopathic scoliosis Vertebral coplanar alignment Vertebral derotation Thoracic kyphosis Sagittal alignment |
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| 中文摘要: |
| 目的 探讨脊柱共平面技术（vertebral coplanar alignment，VCA）对特发性脊柱侧凸的应用效果。方法 回顾性分析在我院接受VCA技术矫形的5例特发性脊柱侧凸病人的临床资料。其中男1例，女4例，平均年龄为16.3岁（14~25岁）。收集术前、术后及最近一次随访时的站立位脊柱全长正侧位X线片及CT，测量主弯Cobb角、顶椎偏移、冠状面平衡、胸椎后凸角（TK）、矢状面平衡、顶椎椎体胸廓比值（apical vertebral body-rib ratio，AVB-R）、顶椎旁肋骨弥散间距（apical rib spread difference，ARSD）、剃刀背（rib hump，RH）及椎体旋转角（rotational angle to sacrum，RAsac）。结果 主弯Cobb角由术前的55.7°矫正至术后的14.7°，TK由术前的26.7°矫正至19.0°。术前Lenke矢状面形态为“+”的病人矫正至“N”，而术前Lenke矢状面形态为“N”的病人仍维持正常的TK。AVB-R、ARSD、RH及RAsac的矫正率分别为36.0%、60.1%、56.7%、54.9%。在24个月的随访期间，无明显矫形丢失，无冠状面、矢状面失代偿发生。结论 VCA技术应用于特发性脊柱侧凸的矫形可获得满意的椎体去旋转和矢状面重建效果。目前针对VCA技术的研究多为初步应用经验，其适应证的选择还需要在今后的临床应用中进一步总结。 |
| 英文摘要: |
| Objective To explore the applied effect of vertebral coplanar alignment (VCA) technique in idiopathic scoliosis. Methods A retrospective analysis was performed on the clinical data of 5 patients with idiopathic scoliosis who received VCA correction technique in our hospital. There was 1 male and 4 females, with an average age of 16.3 years (14-25 years). Standing spine full-length anteroposterior and lateral X-rays and CT scans were collected before and after surgery, and at the latest follow-up. The main Cobb angle, apical vertebral translation, coronal balance, thoracic kyphosis (TK), sagittal balance, apical vertebral body-rib ratio (AVB-R), apical rib spread difference (ARSD), rib hump (RH), and rotational angle to sacrum (RAsac) were measured. Results The main Cobb angle was corrected from 55.7° preoperatively to 14.7° postoperatively, and TK was corrected from 26.7° preoperatively to 19.0° postoperatively. Patients with Lenke sagittal plane morphology of “+” preoperatively were corrected to “N”, and those with Lenke sagittal plane morphology of “N” maintained normal TK. The correction rates of AVB-R, ARSD, RH, and RAsac were 36.0%, 60.1%, 56.7%, and 54.9%, respectively. During the 24-month follow-up period, there was no obvious loss of correction, and no coronal or sagittal plane decompensation occurred. Conclusion VCA technique applied to idiopathic scoliosis can achieve satisfactory vertebral derotation and sagittal plane reconstruction effects. Currently, research on VCA technique is mostly based on preliminary application experience, and the selection of indications still needs to be further summarized in future clinical applications. |
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