青少年胸椎脊椎側彎手術後之影響因子探討

脊椎側彎之手術治療，許多的因子會影響其術後結果，這些影響因子包括：年齡、性別、側彎角度（Cobb angle）、骨骼成熟度（Risser sign）、側向彎曲角度（bending angle）、柔軟度（flexibility）、融合固定節數（fusion level）以及螺釘數（screw）等因素。當側彎角度大於40度時則必須考慮手術進行矯正治療，手術矯正的基本目的不僅是改善外觀畸形，更是使脊椎形成永久的骨性融合．在冠狀面和矢狀面上達到穩固的平衡，並盡可能保留脊椎的運動功能。本研究之目的乃利用統計學的相關分析方法評估各影響因子對術後角度與矯正角度的相關強度。並利用獨立T檢定來檢定各影響因子對手術治療成果是否顯著。經由相關分析方法得知側彎角度對於矯正角度有高度相關性；而側彎角度、側向彎曲角度對於術後角度則有普通相關性。在獨立T檢定方面，可知側彎角度、螺釘數對於矯正角度有顯著差異；而側彎角度、融合固定節數及螺釘數對於術後角度則有差異。由兩種分析方法可以看出，脊椎側彎角度對術後結果是有顯著且非常重要的影響。結果驗證能以側彎角度進行矯正手術施行之參考評估依據。

關鍵字

側彎角度；骨骼成熟度；側向彎曲角度；柔軟度；融合固定節數；螺釘數

並列摘要

Corrective surgery for spinal scoliosis is performed when the Cobb angle is greater than 40 degrees. The main purpose of the operation is to correct the abnormality by fusing the spine in the coronal and sagittal planes while preserving as much spinal mobility as possible. Numerous factors affect the outcome. The results of surgery in 59 cases were examined for correlation with patient age, gender, Cobb angle, Risser sign, bending angle, flexibility, fusion level, and the number of screws. The outcome measures were the post-operative angles and corrected angles. The independent t-test was used to compare the factors. Significant differences were found between Cobb angle and corrected angle, number of screws and corrected angle, Cobb angle and post-operative angle, fusion level and post-operative angle, and the number of screws and post-operative angle. There was a strong correlation between the initial Cobb angle and the corrected angle and a moderate correlation between the Cobb angle and post-operative angle and between the bending angle and post-operative angle. The strong correlation between the Cobb angle and operative outcome supports the use of the Cobb angle as a criterion in deciding to perform spinal surgery in adolescents with scoliosis.

並列關鍵字

Cobb angle ； Risser sign ； bending angle ； flexibility ； fusion level ； screw

國際替代計量

青少年胸椎脊椎側彎手術後之影響因子探討

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