青少年特发性脊柱侧凸患者脊柱骨盆和整体矢状面参数术前和术后的比较分析

Q4 Medicine Coluna/ Columna Pub Date : 2022-01-01 DOI:10.1590/s1808-185120222101250514
Anderson Fellipe Matos de Souza, L. M. Ávila, C. A. Aguiar, Luís Eduardo Munhoz da Rocha
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引用次数: 0

摘要

摘要目的:将青少年特发性脊柱侧凸(AIS)患者分为3组(1组-胸椎融合术、2组-胸腰椎融合术和3组-腰椎融合术),分析其术前和术后椎盂参数和整体矢状平衡,观察这两个时刻的差异,以及这些参数值在术后2年内是否保持。方法:我们分析了99例接受后路内固定关节融合术患者的单中心数据库的x线片。在每位患者的术前和术后x线片上测量骨盆发生率、骨盆形态、骶骨坡度、腰椎前凸、胸后凸和矢状垂直轴值。结果:3组患者盆腔发生率、盆腔形态、骶骨坡度、矢状垂直轴等参数差异无统计学意义。3组术前腰椎前凸比较差异有统计学意义(p = 0.049)。胸后凸在术前值(p = 0.015)和术后值(p = 0.042)均有差异,并在最终的统计分析中显示了术前值和术后值之间的依赖关系。结论:对所分析参数的评估显示,研究组的个体平衡值相似,除了胸后凸和腰椎前凸,这是依赖于手术技术和代偿机制的测量值,但仍在正常范围内。这些因素使外科医生在计划矫正时既要注意冠状面又要注意矢状面,以便在矫正畸形的同时达到躯干的平衡。证据水平IIIA:比较回顾性研究。
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PRE- AND POSTOPERATIVE COMPARATIVE ANALYSIS OF THE SPINOPELVIC AND GLOBAL SAGITTAL PARAMETERS OF PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS
ABSTRACT Objective: To analyze the pre- and postoperative spinopelvic parameters and global sagittal balance of patients with adolescent idiopathic scoliosis (AIS) divided into 3 groups (Group 1 – thoracic arthrodesis, Group 2 - thoracolumbar arthrodesis, and Group 3 – lumbar arthrodesis), observing differences in these two moments and whether the parameter values are maintained or not over a period of up to 2 years following surgery. Methods: We analyzed the radiographs from a single-center database of 99 patients who underwent arthrodesis with posterior instrumentation. Pelvic incidence, pelvic version, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis values were measured in the pre- and postoperative radiographies of each patient. Results: The parameters of pelvic incidence, pelvic version, sacral slope, and sagittal vertical axis did not show statistically significant differences among the 3 groups. There was a difference in preoperative lumbar lordosis between the 3 groups (p = 0.049). Thoracic kyphosis showed differences both in the pre- (p = 0.015) and postoperative (p = 0.042) values, in addition to demonstrating a relationship of dependence between the pre- and postoperative values in the final statistical analysis. Conclusion: The evaluation of the parameters analyzed shows that the study groups have similar values of individual balance, with the exception of thoracic kyphosis and lumbar lordosis, which are measurements that depend on the surgical technique and compensatory mechanisms, but remained within normal ranges. These factors allow the surgeon to be attentive to both the coronal and sagittal planes when planning the correction in order to achieve the equilibrium of the trunk in addition to correction of the deformity. Level of Evidence IIIA: Comparative retrospective study.
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
期刊最新文献
ADOLESCENT IDIOPATHIC SCOLIOSIS: PROGRESSION OF UNTREATED CASES FUNCTIONALITY OF INDIVIDUALS WITH LOW BACK PAIN: CROSS-SECTIONAL STUDY WITH ICF CORE SET ANESTHETIC BLOCK OF THE INTERTRANSVERSE SEPTUM, A PROSPECTIVE OBSERVATIONAL STUDY LUMBAR LORDOSIS VARIATION ACCORDING THE TYPE OF POSITIONER USED IN LUMBAR ARTHRODESIS CLINICAL PHOTOGRAPHIC AND RADIOLOGICAL CORRELATION IN PATIENTS WITH SCOLIOSIS
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