目的:确定现有的评估方法,用于测量青少年特发性脊柱侧凸在支撑前的脊柱灵活性,并评估脊柱灵活性对支撑结果的预测作用。
方法:在PubMed中进行了广泛的文献检索,WebofScience,EMBASE,CINAHL,Scopus,和Cochrane图书馆数据库,以获取有关脊柱灵活性和支撑结果的相关信息。所有文献均于2023年10月14日检索。仔细确定了纳入和排除标准。通过预后研究质量(QUIPS)方法和建议分级评估每个纳入研究的质量和证据水平。评估,发展,和评估(等级)系统,分别。
结果:在筛选了从数据库中检索到的1863篇文章之后,共有14项研究(2,261例受试者)符合本综述的最终分析条件.总的来说,确定了九种灵活性评估方法,包括仰卧位射线照片,仰卧侧弯射线照片,横向弯曲射线照片,但没有明确的位置,挂射线照片,支点弯曲物理方法,和仰卧位置的超声成像,俯卧,坐在侧弯曲和侧弯曲倾向。此外,五项研究表明,灵活性与支撑矫正有很强的相关性,11项研究表明,脊柱灵活性是初始支撑Cobb角支撑结果的预测因素,初始内支撑校正率,曲线进展,和曲线回归。GRADE的结果证明了对脊柱灵活性的预测价值的中等证据评级。
结论:仰卧位摄影是测量前支撑期脊柱灵活性的最常用方法。脊柱灵活性与支架内Cobb角或矫正率密切相关,中度证据支持脊柱灵活性可以预测支撑结果。
OBJECTIVE: To identify the existing assessment methods used to measure the spinal flexibility of adolescents with idiopathic scoliosis before bracing and to evaluate the predictive effect of spinal flexibility on bracing outcomes.
METHODS: A broad literature search was performed in the PubMed, Web of Science, EMBASE, CINAHL, Scopus, and Cochrane Library databases to obtain relevant information about spinal flexibility and bracing outcomes. All literature was retrieved by October 14, 2023. The inclusion and exclusion criteria were meticulously determined. The quality of each included study and the level of evidence were evaluated by the Quality in Prognosis Studies (QUIPS) method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, respectively.
RESULTS: After screening 1863 articles retrieved from databases, a total of 14 studies with 2261 subjects were eligible for the final analysis in this review. Overall, nine methods of flexibility assessment were identified, including supine radiographs, supine lateral bending radiographs, lateral bending radiographs but without clear positions, hanging radiographs, fulcrum bending physical method, and ultrasound imaging in the positions of supine, prone, sitting with side bending and prone with side bending. In addition, five studies demonstrated that flexibility had a strong correlation with in-brace correction, and eleven studies illustrated that spinal flexibility was a predictive factor of the bracing outcomes of initial in-brace Cobb angle, initial in-brace correction rate, curve progression, and curve regression. The results of GRADE demonstrated a moderate-evidence rating for the predictive value of spinal flexibility.
CONCLUSIONS: Supine radiography was the most prevalent method for measuring spinal flexibility at the pre-brace stage. Spinal flexibility was strongly correlated with the in-brace Cobb angle or correction rate, and moderate evidence supported that spinal flexibility could predict bracing outcomes.