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目的:评价支点弯曲位X线片在预测特发性脊柱侧凸患者脊柱矫形融合术效果的价值。方法:对37例特发性脊柱侧凸患者的43个结构性弯曲行术前站立位﹑仰卧侧屈位和支点弯曲位X线摄片,并与术后一周的站立位X线片比较。测量所有Cobb角并进行统计学评价。结果:胸弯组和腰弯组仰卧侧屈位平均Cobb角分别为43°和22°,支点弯曲位平均Cobb角分别为38°和19°,术后Cobb角分别为37°和19°。前路手术组和后路手术组仰卧侧屈位平均Cobb角分别为47°和13°,支点弯曲位平均Cobb角分别为42°和9°,术后Cobb角分别为41°和9°。严重侧弯组和中度侧弯组仰卧侧屈位平均Cobb角分别为52°和22°,支点弯曲位平均Cobb角分别为49°和19°,术后Cobb角分别为45°和20°。僵硬侧弯组和柔软侧弯组仰卧侧屈位平均Cobb角分别为51°和22°,支点弯曲位平均Cobb角分别为48°和17°,术后Cobb角分别为43°和19°。结论:支点弯曲位X线片比传统摄片能更好地评估特发性脊柱侧凸患者在脊柱矫形融合术中所获得的矫正效果,但对严重或较僵硬的侧凸矫形效果预测较差。
Objective: To evaluate the value of fulcrum bending radiographs in predicting the effect of spine orthopedic fusion in patients with idiopathic scoliosis. Methods: Forty-three patients with idiopathic scoliosis underwent X-ray photography of standing position, supine lateral flexion and fulcrum bending position, and compared with standing radiographs one week after surgery. All Cobb angles were measured and statistically evaluated. Results: The mean Cobb angles of the flexion position were 43 ° and 22 ° respectively in the chest flexion group and the lumbar flexion group. The mean Cobb angles of the flexion were 38 ° and 19 °, respectively. The Cobb angles were 37 ° and 19 °, respectively. The mean Cobb angles of the supine lateral flexion were 47 ° and 13 ° respectively in the anterior approach group and the posterior approach group. The average Cobb angles of the fulcrum bending position were 42 ° and 9 °, respectively. Cobb angles were 41 ° and 9 °, respectively. The average Cobb angles of the supine lateral flexion group were 52 ° and 22 ° respectively in the severe and moderate side bending groups, the mean Cobb angles of the fulcrum bending position were 49 ° and 19 °, and the postoperative Cobb angles were 45 ° and 20 ° . The mean Cobb angles of the supine lateral flexion group were 51 ° and 22 ° respectively in the flexion group and the soft flexion group. The mean Cobb angles of the flexion were 48 ° and 17 °, respectively. The Cobb angles were 43 ° and 19 °, respectively. Conclusions: Fulcrum X-ray films are better than traditional radiographs in assessing correction of idiopathic scoliosis in patients with idiopathic spinal fusion but are less predictive of severe or stiff scoliosis .