特发性脊柱侧凸矫形术后躯干失平衡原因分析

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1、◇烹。。：乞焘!特发性脊柱侧凸矫形术后躯干失平衡原因分析荐远端融合范围病例20例，失平衡2例；不符合其推荐远端融合范围病例4l例，失平衡4例。两组之间无统计学差异(p>o．05)。三种分型符合推荐融合节段组比较p>0．05。7、主弯为胸弯病例去旋转和失平衡Cobb角、柔韧性、矫正率、失平衡：两组之间均p>0．05，无统计学差异。8、SRS．22问卷评估功能活动、疼痛、自我形象、心理状况、治疗满意度以及总分：两组之间均p>0．05，无统计学差异。结论l、对于主弯柔韧性差(“0％)，且需融合节段较多的病例

2、，应适当减少主弯矫正率(最好不要超过柔韧性的2倍)。2、对于Risser<4级的病例，参考King分型推荐融合节段可能会减少躯干失平衡的发生。对于Risser>_4级的病例，参考Lenke分型推荐融合节段，可能会保留更多的脊柱运动节段。3、术后失平衡的病例主要通过代偿弯的角度丢失来自我矫正。4、术中去旋转、年龄、性别、侧凸角度大小、主弯部位和术后失平衡的关系还需大宗病例进一步证实。5、术后失平衡的病例，可根据临床影像学结合主观症状来选择治疗方案。关键词特发性脊柱侧凸：躯干失平衡；原因V◇烹点怂特发性脊

3、柱侧凸矫形术后躯干失平衡原因分析ARetrospectiveAnalysisofCausesonPostoperativeTrunkImbalanceforIdiopathicScoliosisMajor：SurgeryName：HuangLingzhiSupervisor：Pro．HuangDongshengAbstractIntroductionIdiopathicscoliosisisnotknowncausesofspinaldeformity，whichspinalinthecoronalp

4、lanedeviatedfromthemiddlelineandformatedthecurvature，oftenaccompaniedbyvertebrarotationandthespinalphysiologicalchangesinsagittalplane．Surgicaltreatmentisusedforpatientswhosecurvesaregreaterthan45。,whilestillgrowingorgreaterthan500，whengrowthhasstopped．

5、Thefinalgoalofsurgicaltreatmentistoimprovethepatient’Slife，S0keepingthetrunkbalanceismoreimportantthanobtainingcurvemaximalcorrection．Becausetrunkimbalancecanleadtodeformitycontinuedtoincrease，backpainorbodycollapse，therebyaffectingtheheart，lungandother

6、importanto玛ans，thatseriousimpactonpatientqualityoflife．TrunkbalanceisdefinedinthewholespineX—rayfilms，includingcoronalandsagittalbalance．Coronaltrunkbalance(CTB)：C7vertebraecemertothesacralmidlinecenter,CTB芝20mmonbehalfoftrunkinthecoronalplaneinlossofba

7、lance．Sagittaltrunkbalance(STB)：thedistancebetweentheS1posterosuperiorcomertoC7plumbline，STB≥20rammpmsentthetrunkinthesagittalplaneatthelossofbalance．Theressonsthatcausesthetrunkimbalamceafteridiopathicscoliosissu唱e巧mayhavethefollowingaspects：1．majorcur

8、veovercorrection；2．distalfusionsegmentschosenincorrect；3．scoliosisclassificationerror；4．poorlumbarcurve／thoraciccuweflexibility；5．intraoperativeover-derotation；6．rigidVI中．1，夫警●q^YM-I蠢II啪M臻■H特发性脊柱侧凸矫形术后躯干失平衡原因分析lumbosacralcurve．In