Lenke 1、2型青少年特发性脊柱侧凸矫形术后内肩自发性平衡6个月观察

Observation of Spontaneous Balance of Internal Shoulder in Patients with Lenke 1 and 2 Adolescent Idiopathic Scoliosis after Corrective Surgery for 6 Months

目的观察Lenke 1、2型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)病人行脊柱后路椎弓根钉矫形内固定植骨融合术后短期内肩自发性平衡的恢复情况。方法回顾性分析2018年1月至2020年1月在本中心行后路椎弓根钉矫形内固定植骨融合术治疗AIS的21例病人手术前后的影像学资料,根据术前、术后即刻、术后6个月标准站立位脊柱全长X线片,测量主胸弯Cobb角、上胸弯Cobb角、腰弯角度、影像学肩高、锁骨角,并采用T1倾斜角和颈椎轴线角评价内肩自发性平衡情况。结果术后即刻和术后6个月的主胸弯Cobb角、上胸弯Cobb角、腰弯角度均较术前明显改善,差异有统计学意义(P<0.05)。术前T1平衡2例(9.52%,2/21),术后即刻6例(28.57%,6/21),术后6个月13例(61.90%,13/21),术后6个月时达到T1平衡的比例较术前显著提高,差异有统计学意义(P<0.05);术前颈部平衡3例(14.29%,3/21),术后即刻13例(61.90%,13/21),术后6个月17例(80.95%,17/21),术后即刻、术后6个月时的颈部平衡比例均较术前显著升高,差异有统计学意义(P<0.05)。结论Lenke 1、2型AIS病人矫形术后内肩平衡(尤其是T1平衡性)会有一定程度的自发性改善。

Objective To observe the recovery of spontaneous balance of internal shoulder in patients with Lenke 1 and 2 adolescent idiopathic scoliosis(AIS)after posterior spinal bone graft fusion and pedicle screw internal fixation.Methods A retrospective analysis was done on the preoperative and postoperative imaging data of 21 patients with AIS who underwent posterior spinal bone graft fusion and pedicle screw internal fixation in our center from January 2018 to January 2020.According to the X-ray films of the full length of the spine in the standard standing position before operation,immediately after operation and 6 months after operation,the Cobb angle of main thoracic curve,Cobb angle of proximal thoracic curve,Cobb angle of lumbar curve,imaging shoulder height and clavicle inclination angle were measured,and T1tilt and cervical axis angle were used to evaluate the spontaneous balance of inner shoulder.Results At 6th month after operation,the main thoracic Cobb angle,proximal thoracic Cobb angle and lumbar Cobb angle were significantly improved as compared with those before operation,and the difference was statistically significant.There were 2 cases of T1balance before operation(9.52%,2/21),6 cases immediately after operation(28.57%,6/21),and 13 cases at 6th month after operation(61.90%,13/21).The proportion of T1balance at 6th month after operation was significantly higher than that before operation,and the difference was statistically significant(P<0.05).Cervical balance was found in 3 cases before operation(14.29%,3/21),immediately after operation in 13 cases(61.90%,13/21),and 17 cases at 6th month after operation(80.95%,17/21).The proportion of neck balance immediately and 6 months after operation was significantly higher than that before operation,and the difference was statistically significant(P<0.05).Conclusion Postoperative idiopathic scoliosis patients with internal shoulder,especially T1balance will have a certain spontaneous improvement.