| 刘思伟,廖小雨,张玉鑫,等.康复治疗后青少年特发性脊柱侧弯患者颈椎矢状面序列变化的研究[J].中华物理医学与康复杂志,2026,48(7):624-629 |
| 康复治疗后青少年特发性脊柱侧弯患者颈椎矢状面序列变化的研究 |
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| DOI：10.3760/cma.j.cn421666-20250601-00454 |
| 中文关键词: 青少年特发性脊柱侧弯 颈椎矢状面平衡 康复治疗 颈椎前凸角 |
| 英文关键词: Adolescent idiopathic scoliosis Sagittal balance Cervical spine Conservative treatment Cervical lordosis angle |
| 基金项目:昆山市级科研专项（KS2540）；2025年度苏州市科协青年科技人才托举工程项目 |
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| 中文摘要: |
| 目的 观察青少年特发性脊柱侧弯（AIS）患者康复治疗显效后颈椎矢状面序列的变化。 方法 回顾性分析2018年1月～2025年6月经脊柱侧弯特异性运动疗法（PSSE）和核心稳定性训练后显效的AIS患者46例的资料，比较所有患者初次检查（康复治疗前）和复查时（康复治疗显效后）站立位全脊柱正侧位X线片中颈椎矢状面的影像学参数，包括颈椎前凸角（CL）、颈椎矢状面轴向距离（cSVA）和T1倾斜角（T1S），并根据侧弯类型（胸弯、腰弯和S弯）进行亚组分析，同时采用Pearson相关性分析评估各影像学参数间的相关性。 结果 复查时，AIS患者的Cobb角和C2～C7 CL分别为（15.23±6.36）°和（-3.99±10.88）°，较初次检查时的（17.04±5.91）°和（-0.30±14.42）°均明显缩小，差异均有统计学意义（P＜0.05）。复查时，胸弯AIS患者的Cobb角，以及腰弯AIS患者的Cobb角和C2～C7 CL较同侧弯类型初次检查时均明显缩小，差异均有统计学意义（P＜0.05）。相关性分析显示，C2～C7 CL与cSVA在初次检查时（r=-0.404）和复查时（r=-0.411）均呈显著负相关（P＜0.05）；C2～C7 CL与T1S在初次检查时（r=0.762）和复查时（r=0.507）均呈显著正相关（P＜0.001）。 结论 AIS患者接受康复治疗初步控制住脊柱侧弯的进展后，其C2～C7 CL仍呈现进行性缩小趋势，而cSVA和T1S会发生代偿性调整以维持颈椎矢状面的平衡。 |
| 英文摘要: |
| Objective To document the changes in sagittal alignment of the cervical spine of patients with adolescent idiopathic scoliosis (AIS) after an initial course of effective rehabilitation. Methods This was a retrospective analysis of 46 AIS patients who showed an initial therapeutic response to a course of scoliosis-specific physiotheraputic exercises (PSSE) and core stability training. Cervical lordosis (CL), the cervical sagittal vertical axis (cSVA) and T1 slope (T1S) were measured from standing whole-spine radiographs obtained at baseline and at follow-up. Subgroup analyses were performed based on the subjects′ thoracic, lumbar and double major/S-shaped curve patterns. Results At follow-up the mean Cobb angle was (15.23±6.36)° and the mean C2-C7 CL was (-3.99±10.88)°. Both showed a statistically significant reduction compared to the baseline values of (17.04±5.91)° and (-0.30±14.42)° respectively. Subgroup analysis revealed significant reductions in the Cobb angle for the thoracic curve group, and in both Cobb angle and C2-C7 CL for the lumbar curve group. C2-C7 CL and cSVA showed a significant negative correlation both at baseline (r=-0.404) and at follow-up (r=-0.411), and C2-C7 CL and T1S were also significantly correlated at both time points (r=0.762 and r=0.507, respectively). Conclusions Rehabilitation successfully arrests curve progression for AIS patients, and C2-C7 CL exhibits a progressive decreasing trend. Concurrently, cSVA and T1S adjust to maintain cervical sagittal balance. |
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