支具矫正联合姿态训练治疗青少年特发性脊柱侧弯

Bracing treatment combined with postural training in adolescent idiopathic scoliosis

目的探讨支具矫正联合姿态训练对于青少年特发性脊柱侧弯(AIS)的临床疗效以及影响因素。方法将136例AIS患者行胸腰骶支具联合姿态矫正训练,定期摄X线片检查患者脊柱Cobb角,同时总结影响治疗方案的相关因素。结果随访12～18个月,136例中76例坚持完成疗程。76例胸椎Cobb角从治疗前27. 8°±5. 3°矫正至19. 6°±3. 1°,腰椎Cobb角从治疗前29. 7°±4. 2°矫正至20. 4°±2. 6°,差异有统计学意义(P <0. 05)。Logistic多因素回归分析:初诊Cobb角≥35°、脊柱长度增长速度≥20 mm/年、Rsisser指数> 3级、脊柱柔韧度<50%是影响治疗方案的独立危险因素。结论支具矫正联合姿态训练对于AIS具有良好的临床疗效,初诊Cobb角≥35°、脊柱长度增长速度≥20 mm/年、Rsisser指数> 3级、脊柱柔韧度<50%、顶椎旋转度≥3级与治疗效果密切相关。

Objective To investigate the clinical effect and influence factors of bracing treatment combined with postural training in adolescent idiopathic scoliosis(AIS).Methods The 136 AIS patients were trained for combined posture correction of thoracolumbar and sacral branches.Regular X-ray examination of the patient′s spine Cobb angle was conducted,and the factors influencing the treatment regimen were summarized.Results All cases were followed-up for 12~18 months.Of the 136 cases,76 patients completed the treatment,76 cases of thoracic vertebral Cobb angles were corrected from 27.8°±5.3°before treatment to 19.6°±3.1°,lumbar Cobb angles from 29.7°±4.2°before treatment to 20.4°±2.6°,the differences were statistically significant(P<0.05).Logistic multifactor regression analysis:first visit Cobb angle was≥35°,spine length growth rate was≥20 mm per year,Rsisser index was more than 3 grade,the flexibility of spine<50%,which were the independent risk factors of treatment.Conclusions Brace joint posture training for adolescent idiopathic scoliosis has good clinical curative effect,newly diagnosed Cobb angle≥35°,spine length growth rate is more than 20 mm per year,Rsisser index is more than 3 grade,the flexibility of spine<50%,the flexibility of the apical vertebral rotation is greater than or equal to 3 grade,and treatment effect is closely related.