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目的:通过青少年特发性脊柱侧凸的4种术前数字X线摄影,分析适宜的摄影体位及影像,评估临床脊柱矫形的预测矫正数据。方法:对42例特发性脊柱侧凸患者的53个结构性弯曲行术前脊柱站立正位、仰卧牵引正位、仰卧侧屈正位及支点侧屈正位数字X线摄影,比较摄影特点计算校正率,并与术后站立位影像对比。测量所有Cobb角并进行统计学评价。结果:术前胸弯组和腰弯组中,仰卧牵引正位平均Cobb角分别为(43±2)°和(38±2)°,支点侧屈正位平均Cobb角分别为(35±1)°和(19±1)°,术后的Cobb角分别为(32±1)°和(18±1)°;仰卧侧屈正位平均Cobb角分别为(41±2)°和(33±2)°,支点侧屈正位Cobb角分别为(29±1)°和(12±1)°,术后Cobb角分别为(27±1)°和(12±1)°。术前及术后Cobb角之间比较:支点侧屈正位无显著性差异,而仰卧牵引正位和仰卧侧屈正位有显著性差异,(P<0.05)。支点侧屈正位校正度与校正率均大于仰卧牵引正位及仰卧侧屈正位。结论:站立正位和支点侧屈正位可保持同一状态下重复性的摄影姿势,能主动配合且易标准化。支点侧屈正位能真实反映侧凸的僵硬程度及柔韧度,较准确地预测脊柱侧凸矫形的校正度。
OBJECTIVE: To evaluate the preoperative correction of spinal orthopedic data by four kinds of preoperative digital radiography of adolescent idiopathic scoliosis. Methods: Fifty-nine patients with idiopathic scoliosis underwent preoperative spinal spine orthosis, supine traction orthosis, supine lateral flexion and fulcrum lateral flexion anteroom digital radiography, and compared the characteristics of photography Calculate the correction rate, and postoperative contrast image. All Cobb angles were measured and statistically evaluated. Results: The mean Cobb angles of the supine position were (43 ± 2) ° and (38 ± 2) ° respectively in the preoperative thoracic and lumbar curves, and the average Cobb angles of the lateral and lateral flexion were (35 ± 1) Cobb angles were (32 ± 1) ° and (18 ± 1) °, respectively. The average Cobb angles were (41 ± 2) ° and ± 2 °, and the Cobb angles at the fulcrum lateral flexion were (29 ± 1) ° and (12 ± 1) °, respectively. Cobb angles were (27 ± 1) ° and (12 ± 1) °, respectively. There was no significant difference between the preoperative and postoperative Cobb angles. There was a significant difference between the supine lateral position and supine lateral position (P <0.05). Spindle lateral flexion correction and correction rate are greater than supine traction and supine lateral flexion position. Conclusion: The standing position and the fulcrum lateral flexion position can maintain the same photographic posture under the same condition, which can take the initiative to cooperate and easy to standardize. The fulcrum lateral flexion can truly reflect the stiffness and flexibility of scoliosis, and more accurately predict the correction of scoliosis orthosis.