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肩胛骨成形术治疗脊柱侧弯双肩失衡临床研究

Shoulder imbalance treated by scapula-plasty in scoliosis patients: a retrospective study
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摘要 目的:探讨肩胛骨成形术治疗脊柱侧弯患者双肩失衡的临床疗效与安全性。方法:回顾性分析我院2013年9月至2015年3月进行脊柱侧弯矫形术并同期行肩胛骨成形手术的患者21例,随访24~42个月[平均(31.4±5.3)个月],比较患者术前与术后及末次随访时的外观双肩高度差、改良Constant-Murley评分、肩关节活动度、Cavendish评分及患者总体满意度,并通过统计分析评估该术式中远期临床疗效。结果:术后及末次随访患者的外观双肩高度差较术前显著性减小(P<0.05),患者双肩高度差由术前的(3.2±1.1)cm降至末次随访时的(0.4±0.3)cm,Cavendish评分亦降为1分;患者改良Constant-Murley评分及肩关节活动度于术前、术后及末次随访均无显著性差异(P>0.05);术后至末次随访间无任何并发症出现。结论:肩胛骨成形术能显著性改善术前高低肩,达到术后双肩平衡,提高患者及家属满意度,且不影响肩关节的活动功能,值得临床推广应用。 Objective: To discuss the clinical efficacy and safety of scapula-plasu for the shoulder imbalance in scoliosis patients. Methods : A retrospective analysis was made in 21 patients who underwent scoliosis orthopaedics and scapula-plasty from September 2013 to March 2015. They were followed up for (31.4 ± 5.3) months on average( ranged from 24 to 42 months). The shoulder height difference(SHD) , adjusted Constant-Murley score, range of shoulder motion, Cavendish score and the overall satisfaction were compared among the pre-surgery, post-surgery and final follow-up periods. And then the mediunl and long-term clinical effect of this procedure was evaluated by statistical analysis. Results : The SHD significantly decreased at the time of post- surgery and the final follow-up, compared with the value of pre-surgery. The SHD of all patients decreased from preoperatively mean (3.2 ±1. 1 ) cm to mean ( 0. 4 ±0. 3 ) cm, and the Cavendish score was improved to 1 point at the final follow-up. The Constant-Murley score and the range of shoulder motion showed no significant differences among the three periods ( P 〉 0. 05 ). No long-term complications occurred. Conclusion: The seapula-plasty is an effective procedure to improve the shoulder imbalance, cosmetic appearance and the overall patient satisfaction in seoliosis patients without impairing the shoulder function, which can be widely applied in clinic.
作者 钟锐 梁益建 胡正军 汪飞 赵登 赵贺红 ZHONG Rui;LIANG Yijian;HU Zhengjun;WANG Fei;ZHAO Deng;ZHAO Hehong(Spine Surgery,Chengdu Third People's Hospital,Chengdu,Sichuan 610031,China)
出处 《现代临床医学》 2018年第4期259-261,共3页 Journal of Modern Clinical Medicine
关键词 脊柱侧弯 肩部失衡 肩胛骨成形 矫正 scoliosis shoulder imbalance scapula-plasu correction
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