| Objective1.Measurement of Chinese adolescent idiopathic scoliosis patients using three-dimensional CT technology of lumbar and thoracic pedicle diameter;2.Summary our country adolescent idiopathic of scoliosis in patients with lumbar and thoracic pedicle diameter variation laws through the analysis of the obtained data;3.Of the youth of our country combined with idiopathic of scoliosis in patients with lumbar and thoracic pedicle diameter variation laws of Lenke 1 adolescent idiopathic scoliosis selective fusion range of options to provide help.Methods1.Retrospective analysis of the clinical data of the Second Affiliated Hospital of Kunming Medical University from 2010 July to 2014 December in Department of orthopedics in our department rcveived 45 cases of adolescent scoliosis operation in the treatment of idiopathic scoliosis patients with scoliosis, using three-dimensional CT technology from T1-L5 were measured in 45 patientd with bilateral pedicle of vertebral arch root diameter. According to gender, age,major curve in patients with apical vertebra region,scoliosis Lenke type,the major curve Cobb angle,bending flexibility,apical vertebral rotation and thoracic correction of 45 patients were divided into different groups,Tl-L5ratio in patients with concave and convex side and concave side of vertebral arch pedicle diameter of root diameter. The data were statistically analyzed with SPSS 17.0 foftware,comparison of various influencing factors Chinese idiopathic scoliosis patients with T1-L5 pedicle straight.2.The three cases of postoperative thoracic decompensation were divided into a group, for T1-L5 convex side TPD the mean and standard deviation (Mean+ SD). The upper thoracic curve loss compensatory group T1-L5 convex side TPD and convex side TPDR distribution regularity and 45 patients in accordance with Lenke grouping of each T1-L5 convex side TPD and convex side TPDR distribution were compared, in order to find out the existence of similar and difference analysis.Results1.Male patients with AIS T1-L5 TPD were higher than the concave side of female patients with ipsilateral segmental TPD,in the lumbar (L1-L5) with statistical significance of this trend(P<0.05); 2.Patients with AIS and T1-L5 decreased with the increase of age,the convex side of TPD showed a trend of change from small to big and small,concave side of the TPD T1-L5 show a decreasing trend with the increase of age,TPDR is located on the concave side thoracic and thoracic apical region of T3 and T8 in two segments with statistical difference(P<0.05),and the older,the symmetry of the worse; 3.Patients in each group according to the Lenke classification of thoracic pedicle morphology the concave side were realized as TPD less than the same segment of the convex side of the minimum TPDR value, namely the apex region of the asymmetric development of concave and convex side of the pedicle.Lenke 1 and Lenke 3 in patients with lumbar concave and convex side TPDR is greater than 1,indicating that two groups of patients with lumbar scoliosis TPD asymmetry for TPD greater than the same segment concave convex side TPD.4.According to the thoracic spine correction group, compared with normal group and T1-L5 group patients with thoracic lordosis of concave and convex side TPD,normal group AIS patients most vertebral concave side were higher than TPD group at the same side with segmental lordosis group’s TPD,the asymmetry of the concave and convex side of the pedicle and T1-L5 development is more obvious; 5.1n accordance with the main bending flexibility in each group,and between the concave convex side TPDR and concave convex TPD is no statistically significant difference(p>0.05).6.According to the apical vertebral rotation group,except the 0 group,the other 3 group of concave and convex side of tpd were decreased with the increase of TPD were decreased with the increasw of apical vertebral rotation,concave and convex side of TPDR showed no significant change.7.According to the main curve Cobb angle grouped,AIS was found in patients with T2-L4 segment of concave and convex side TPD as main curve Cobb angle increase and smaller,concave and conve side of TPDR showed no significant change.8.According to the apical vertebra region found in T1-L1 segment, T5-T11 group convex side TPD was larger than that in group T12-L5,but the L2-L5 segment of T5-T11 group’s convex side TPD were lower than that in group T12-L5,in the concave side except T2 segment,T5-T11 group’s concave side TPD biger than T12-L5 group’s TPD in the same side and segment.9. In bending loss compensatory group and Lenkel type patients T1-L5 convex side TPDR distribution trend has a certain similarity, and Lenke2 patients with thoracic convex side TPDR distribution trend and similar.Conclusion1.AIS patients with T1-L5 bilateral pedicle diameter change trend and normal adolescents were similar, but the diameter of the convex side pedicle is obviously asymmetric, this asymmetry at the top of the vertebral region is particularly evident.2. Male AIS patients than in female patients with AIS pedicle diameter growth, this phenomenon is most obvious in the lumbar segment.3.Thoracic curve and main thoracic curve top zone concave and convex side of the vertebral pedicle diameter developmental asymmetry affected by age, older is concave and convex side TPD symmetry worse.4.Different Lenke type of AIS patients, the asymmetry of the thoracic pedicle diameter performance concave side pedicle diameter less than that of the convex side of the pedicle diameter, but Lenke type 1 and Lenke type 3 patients of lumbar pedicle diameter of asymmetry performance for concave side pedicle diameter greater than the diameter of the same section of the convex side of the vertebral arch root.5. Accompanied by thoracic lordosis of AIS patients pedicle diameter developed widely than thoracic correction AIS patients with normal and convex side pedicle diameter of asymmetry of lordosis group is more obvious.6.AIS patients of thoracic and lumbar vertebrae convex side pedicle diameter increased with the main bending apical vertebral rotation and Cobb angle and convex side pedicle diameter asymmetry in apical region showed the most obvious. But the effect of concave side pedicle diameterwithout lateral bending flexibility.7. Thoracic scoliosis AIS patients, the main bending TPD developmental asymmetry than compensatory bending TPD developmental asymmetry, bent based AIS patients with thoracic compensatory bending TPD developmental asymmetry than lumbar curve TPD developmental asymmetry.8.Lenkel type of compensatory AIS patients, if preoperative measurements revealed the thoracic curve convex side TPD has great difference, it will into the upper thoracic curve fusion range can reduce the incidence of upper thoracic curve decompensation. |
PDF Full Text Request