背景:支撑是脊柱侧凸治疗的重要组成部分。今天,脊柱侧凸患者的支架治疗标准在支架质量和结果方面仍然存在很大差异。Gensingen支架是具有个性化设计的进一步开发的Chäneau支架衍生物,可以通过计算机辅助设计进行调整。
目的:本研究旨在生成一个模板,以获得前瞻性多中心研究研究的数据库,以分析青少年特发性脊柱侧凸(AIS)患者的高度矫正不对称Gensingen支具治疗的结果。
方法:创建了数据库模板,其中包含患者的基本数据(年龄,月经状态,Risser标志,曲线模式,和每日支具佩戴时间),Cobb曲率角,和躯干旋转(ATR)的美容相关角度。对AIS患者的病历进行回顾性回顾,符合脊柱侧弯研究协会对支撑研究的纳入标准,进行了模板的可行性测试。模板项目由研究人员填写。
结果:在2014年至2018年的115例患者中,可以分析33例患者在完全Gensingen支撑撤机后至少3个月随访的完整数据。平均年龄是12岁,平均Cobb角为33.6°,治疗开始时的平均Risser值为0.7。支架内X射线成像的Cobb角平均改善为-26.1(支架内矫正的80%)。主要曲率的Cobb角变化如下:在7例(21.2%)中实现了曲线稳定,曲线改善26例(78.8%)。没有患者显示曲线进展。在治疗结束和随访评估时,支架的Cobb角显着降低(P<.001)。胸椎(P<.001)和腰椎曲线(P<.001)的ATR明显改善。
结论:该数据库被证明在评估放射学和临床结果参数方面提供了信息。我们生成的示例数据集对于在诊所工作但不存储常规患者数据的专业人员来说是一个有用的工具。特别是关于世界各地不同的患者团体,使用相同的护理标准可能会获得不同的结果。此外,这项研究的结果表明,在完成支具治疗后,采用全时支具的矫正效果高于平均水平导致Cobb角的显著改善.
BACKGROUND: Bracing is an essential part of scoliosis treatment. The standard of brace treatment for patients with scoliosis today is still very variable in terms of brace quality and outcome. The Gensingen brace is a further developed Chêneau brace derivative with individual design, which can be adapted through computer-aided design.
OBJECTIVE: This study aims to generate a template to obtain a database for prospective multicenter studies study to analyze the results of high-corrective asymmetric Gensingen brace treatment for patients with adolescent idiopathic scoliosis (AIS).
METHODS: A template for the database was created, which contains the patients\' basic data (age, menarcheal status, Risser Sign, curve pattern, and daily brace wearing time), the Cobb angles of curvature, and the cosmetically relevant angles of trunk rotation (ATR). A retrospective review of medical records of patients with AIS, who met the Scoliosis Research Society\'s inclusion criteria for brace studies, was performed to test the feasibility of the template. Template items were filled in by the researchers.
RESULTS: Out of 115 patients between 2014 and 2018, the complete data of 33 patients followed up at least 3 months after complete Gensingen brace weaning could be analyzed. The mean age was 12 years, the mean Cobb angle was 33.6°, and the mean Risser value was 0.7 at the beginning of the treatment. The mean improvement in the Cobb angle on in-brace x-ray imaging was -26.1० (80% of in-brace correction). The Cobb angle of the major curvature changed as follows: curve stabilization was achieved in 7 (21.2%) cases, and curve improvement was achieved in 26 (78.8%) cases. None of the patients showed a curve progression. The Cobb angle was significantly reduced in the brace at the end of treatment and at follow-up evaluation (P<.001). ATR improved significantly for thoracic (P<.001) and lumbar curves (P<.001).
CONCLUSIONS: The database proved to be informative in the assessment of radiological and clinical outcome parameters. The example data set we have generated can be a helpful tool for professionals who work in clinics but do not store regular patient data. Especially with regard to different patient collectives worldwide, different results may be achieved with the same standards of care. In addition, the results of this study suggest that above-average correction effects with a full-time brace application lead to significant improvements in the Cobb angle after brace treatment has been completed.