牵引下仰卧全脊柱拼接片投照技术与临床应用效果分析

Analysis of Technique and Clinical Application of Supine Whole Spine Splice Radiography in Traction

目的:研究牵引下仰卧全脊柱拼接片对于中重度脊柱侧弯矫正手术的临床应用价值。方法:回顾性选取本院2018年4月至2020年12月进行牵引下负重全脊柱(颈椎—胸椎—腰椎—骨盆)正侧拍摄患者为研究对象,按要求筛选,共纳入54例病例,记录并统计患者年龄、性别、Cobb角、主弯、顶椎偏移距离类型等情况,其中24例为家人辅助牵引负重,30例为机械辅助装置牵引负重。进行站立位和负重位图像质量分析及所得数据对比。结果:对图像结果进行统计分析,结果表明,牵引后Cobb角差(26.80±1.79)、顶椎偏移距离差(0.29±0.60)、PO差(9.00±1.09)、RSH差(0.50±0.20),与站立位相比差异具有统计学意义(P<0.05)。在家属辅助牵引中配合差导致图像数据无意义8例,成功16例;机械负重辅助装置牵引中配合差导致图像无意义2例,成功28例。结论:对于患有中、重度脊柱侧弯的患者,进行负重牵引下DR全脊柱拼接片所拍摄图像测得Cobb角、PO、RSH、顶椎偏移距离等数据,可为制定手术矫正方案提供重要参考意义。

Objective:To evaluate the application of traction supine whole spine splices in the correction of moderate and severe scoliosis.Methods:From April 2018 to December 2020,54 patients were retrospectively selected for anterior and lateral photography of the whole spine(cervical-thoracic-lumbar-pelvis)under weight-bearing traction in our hospital.After screening as required,a total of 54 cases were included,with the age,gender,Cobb angle,main curve,apical vertebra offset distance type recorded and counted,of which 24 cases were family-assisted weight-bearing traction and 30 cases were mechanical auxiliary device weight-bearing traction.The image quality of the standing position and weight-bearing position was analyzed and the related data were compared.Results:The statistically analyzed images(see Table 1)showed that Cobb angle(26.80±1.79),apical vertebra offset distance(0.29±0.60),PO(9.00±1.09),and RSH(0.50±0.20)after traction were significantly different from those in standing position(P<0.05).In family-assisted weight-bearing traction,8 cases had insignificant image data due to poor coordination,and 16 cases succeeded.In mechanical auxiliary device weight-bearing traction,2 cases had insignificant image data due to poor coordination,and 28 cases succeeded.Conclusion:For patients with moderate and severe scoliosis,the Cobb angle,PO,RSH,apical vertebra offset distance,and other data measured from the images taken by DR whole spine splices under weight-bearing traction provide important reference significance for formulating surgical correction scheme.