选择适当的支具佩戴治疗特发性脊柱侧凸青少年患者的临床效果及预后
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摘要
目的探讨选择适当的支具佩戴对特发性脊柱侧凸青少年患者的临床效果及预后。方法选取温州医科大学附属黄岩医院骨科2013年1月—2016年1月期间的18例青少年特发性脊柱侧凸患者,根据治疗方法分为2组,每组9人,研究组佩戴适当的支具进行治疗,对照组使用电刺激疗法,9个月后进行随访,分析整理Risser征级别和Cobb角对矫正结果的影响,通过对比2组的治疗总有效和生活质量满意度评分,对2组患者的临床疗效和预后生活质量差异进行评价。结果研究组的治疗总有效率为88.89%,对照组为66.67%(P>0.05);研究组和对照组各有1例(11.11%)和3例(33.33%)并发症发生,并发症发病率差异无统计学意义(P>0.05);Risser征级越低,初诊矫正率、侧凸进展率越高,顶锥旋转矫正率并未表现出规律,不同Risser征级下初诊矫正率差异有统计学意义(P<0.05),而侧凸进展率和顶锥旋转矫正率无显著差异(P>0.05);研究组在功能/活动度、疼痛、精神健康和治疗满意度上的评分均高于对照组,差异具有统计学意义(P<0.05)。结论佩戴合适的支具可有效地降低青少年特发性脊柱侧凸患者侧凸进展,提高生活质量,值得在轻中度青少年特发性脊柱侧凸患者中推广使用。
Objective To investigate the effect appropriate brace-wear in patients with adolescent idiopathic scoliosis.Methods Total 18 cases of adolescent idiopathic scoliosis in our hospital from January,2016 were divided into treatment group( n = 9) and control group( n = 9). The treatment group received appropriate brace-wear treatment,while the control group received electrical stimulation therapy. Nine months later,the influence of Risser sign and Cobb angle on the result of correction was analyzed The total effectiveness and life quality satisfaction were compared between the two groups. Results Total effective rate was 88. 89% in the treatment group,which was better than that of control group( 66. 67%),P > 0. 05. The incidence of complications were 11. 11% and 33. 33% in treatment group and control group,respectively,there was no significant differences between the two groups( P > 0. 05). The lower the Risser grade was,the higher first diagnosis correct rate and side convex progress rate develop. The first diagnosis correct rate,but not side convex progress rate and top cone rotation correction rate,were differently between the patients with different Risser grade( P < 0. 05). The function/mobility,pain,mental health and satisfaction score of the treatment group were higher than those of control group( P < 0. 05). Conclusion Brace treatment can reduce side convex progression and improve the quality of life in patients with adolescent idiopathic scoliosis,especially the patients with mild-to-moderate AIS.
Objective To investigate the effect appropriate brace-wear in patients with adolescent idiopathic scoliosis.Methods Total 18 cases of adolescent idiopathic scoliosis in our hospital from January,2016 were divided into treatment group( n = 9) and control group( n = 9). The treatment group received appropriate brace-wear treatment,while the control group received electrical stimulation therapy. Nine months later,the influence of Risser sign and Cobb angle on the result of correction was analyzed The total effectiveness and life quality satisfaction were compared between the two groups. Results Total effective rate was 88. 89% in the treatment group,which was better than that of control group( 66. 67%),P > 0. 05. The incidence of complications were 11. 11% and 33. 33% in treatment group and control group,respectively,there was no significant differences between the two groups( P > 0. 05). The lower the Risser grade was,the higher first diagnosis correct rate and side convex progress rate develop. The first diagnosis correct rate,but not side convex progress rate and top cone rotation correction rate,were differently between the patients with different Risser grade( P < 0. 05). The function/mobility,pain,mental health and satisfaction score of the treatment group were higher than those of control group( P < 0. 05). Conclusion Brace treatment can reduce side convex progression and improve the quality of life in patients with adolescent idiopathic scoliosis,especially the patients with mild-to-moderate AIS.
引文
[1]方明桥,王翀,项光恒,等.Cheneau支具佩戴依从性对青少年特发性脊柱侧凸患者生存质量及疗效的影响[J].中国脊柱脊髓杂志,2014,24(9):784-789.
[2]Brox JI,Lange JE,Gunderson RB,et al.Good brace compliance reduced curve progression and surgical rates in patients with idiopathic scoliosis[J].European Spine Journal,2012,21(10):57-63.
[3]Karol LA,Virostek D,Felton K,et al.Effect of Compliance Counseling on Brace Use and Success in Patients with Adolescent Idiopathic Scoliosis[J].Journal of Bone&Joint Surgery American,2016,98(1):9-14.
[4]Cuddihy L,Danielsson AJ,Cahill PJ,et al.Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis[J].Biomed Research International,2015,5(4):1-7.
[5]Paolucci T,Morone G,Di CA,et al.Effect of Cheneau brace on postural balance in adolescent idiopathic scoliosis:a pilot study[J].European Journal of Physical&Rehabilitation Medicine,2013,49(5):649-657.
[6]张勇,杨毅军,赵黎,等.支具治疗对女性青少年特发性脊柱侧凸心理的影响分析[J].实用骨科杂志,2014,7(8):684-686.
[7]赵自平,兰海峰,冯建忠,等.Providence夜用型支具治疗青少年特发性脊柱侧凸的效果分析[J].中国当代医药,2014,21(17):26-28.
[8]Gozde G,Burcu D,Cigdem A,et al.Effect of a spinal brace on postural control in different sensory conditions in Adolescent Idiopathic Scoliosis:A preliminary analysis[J].Gait&Posture,2015,41(1):93-95.
[9]Fang MQ,Wang C,Xiang GH,et al.Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis[J].Journal of Neurosurgery Spine,2015,23(4):1-5.
[10]Kuroki H,Inomata N,Hamanaka H,et al.Significance of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients[J].Scoliosis,2012,7(1):8-10.
[11]李政垚,王以朋,于斌,等.马方及类马方综合征脊柱侧凸与青少年特发性脊柱侧凸患者肺功能障碍的差异性比较[J].中国脊柱脊髓杂志,2015,25(8):728-732.
[12]Schwieger T,Campo S,Weinstein SL,et al.Body Image and Qualityof-Life in Untreated Versus Brace-Treated Females with Adolescent Idiopathic Scoliosis[J].Spine,2015,41(4):15-18.
[13]Chan A,Lou E,Hill D.Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis[J].Journal of Children Orthopaedics,2013,7(4):309-316.
[14]Chan SL,Cheung KM,Luk KD,et al.A correlation study between inbrace correction,compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis[J].Scoliosis,2014,9(1):10-12.
[2]Brox JI,Lange JE,Gunderson RB,et al.Good brace compliance reduced curve progression and surgical rates in patients with idiopathic scoliosis[J].European Spine Journal,2012,21(10):57-63.
[3]Karol LA,Virostek D,Felton K,et al.Effect of Compliance Counseling on Brace Use and Success in Patients with Adolescent Idiopathic Scoliosis[J].Journal of Bone&Joint Surgery American,2016,98(1):9-14.
[4]Cuddihy L,Danielsson AJ,Cahill PJ,et al.Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis[J].Biomed Research International,2015,5(4):1-7.
[5]Paolucci T,Morone G,Di CA,et al.Effect of Cheneau brace on postural balance in adolescent idiopathic scoliosis:a pilot study[J].European Journal of Physical&Rehabilitation Medicine,2013,49(5):649-657.
[6]张勇,杨毅军,赵黎,等.支具治疗对女性青少年特发性脊柱侧凸心理的影响分析[J].实用骨科杂志,2014,7(8):684-686.
[7]赵自平,兰海峰,冯建忠,等.Providence夜用型支具治疗青少年特发性脊柱侧凸的效果分析[J].中国当代医药,2014,21(17):26-28.
[8]Gozde G,Burcu D,Cigdem A,et al.Effect of a spinal brace on postural control in different sensory conditions in Adolescent Idiopathic Scoliosis:A preliminary analysis[J].Gait&Posture,2015,41(1):93-95.
[9]Fang MQ,Wang C,Xiang GH,et al.Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis[J].Journal of Neurosurgery Spine,2015,23(4):1-5.
[10]Kuroki H,Inomata N,Hamanaka H,et al.Significance of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients[J].Scoliosis,2012,7(1):8-10.
[11]李政垚,王以朋,于斌,等.马方及类马方综合征脊柱侧凸与青少年特发性脊柱侧凸患者肺功能障碍的差异性比较[J].中国脊柱脊髓杂志,2015,25(8):728-732.
[12]Schwieger T,Campo S,Weinstein SL,et al.Body Image and Qualityof-Life in Untreated Versus Brace-Treated Females with Adolescent Idiopathic Scoliosis[J].Spine,2015,41(4):15-18.
[13]Chan A,Lou E,Hill D.Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis[J].Journal of Children Orthopaedics,2013,7(4):309-316.
[14]Chan SL,Cheung KM,Luk KD,et al.A correlation study between inbrace correction,compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis[J].Scoliosis,2014,9(1):10-12.