痉挛型脑瘫儿童腰椎发育特点及稳定性分析

The analysis to the lumbar spine growth characteristic and stability statues of spastic cerebral palsy children

目的:探讨痉挛型脑瘫儿童腰椎发育及稳定性特点。方法:对189例痉挛型脑瘫患儿及48例对照组儿童进行腰椎X线对比分析,观察腰椎发育及畸形情况,测量腰骶关节倾斜度,侧位腰椎前凸角(侧位腰椎Cobb角)、弓顶距离及前凸指数等,以及侧位过伸过屈动力位胸腰段(T12-L1、L1-L2)、腰骶段(L4-L5、L5-S1)椎体相对位移(Posner指数)等指标。结果:痉挛型脑瘫儿童腰椎发育不良及畸形发生率、腰骶关节倾斜度、侧位腰椎Cobb角、弓顶距离及前凸指数,以及腰骶段(L4-L5、L5-S1)Posner指数与对照组儿童差异有显著性意义(P<0.05,P<0.01),胸腰段(T12-L1、L1-L2)Posner指数差异无显著性意义(P>0.05)。结论:痉挛型脑瘫儿童腰椎存在不稳因素,发育不良,畸形等发生率较普通儿童高,上腰段(T12-L2)较下腰段(L4-S1)稳定。

Objective： To explore the lumbar spine growth characteristic and stability statues of spastic cerebral palsy children. Method： The lumbar X-ray films （including orthotopic and lateral dynamic position lumbar films） of 189 cases of spastic cerebral palsy children and 48 controlled cases were studied and analyzed. Result： The instability deformity, lumbosacral angle, lateral Cobb＇s angle and lower lumbar Posner＇s definition （L4-S1） had significant difference between two groups, while the Posner＇s definitions of upper lumbar（T12-L2） had no significant difference. Condusion： The spastic cerebral palsy children have the higher trend of spinal instability, hypoplasia and deformity incidence of their lumbar spine than normal and their instability of upper lumbar （T12-L2） are superior to lower lumbar（L4-S1 ）.