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-  2015 

智能手机Scoliometer软件在L4~S1融合术中获得最优化腰椎前凸角的价值

DOI: doi:10.7507/1002-1892.20150271

Keywords: Scoliometer软件, L4~S1融合术, Cobb角, 骨盆入射角, 腰椎前凸角

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Abstract:

目的探讨智能手机Scoliometer软件在L4~S1融合术中获得最优化腰椎前凸角(lumbar lordosis,LL)的价值,并观察其准确性。 方法将2014年11月-2015年2月收治并拟行L4~S1融合术的20例腰椎退行性疾病患者纳入研究。男8例,女12例;年龄41~65岁,平均52.3岁。病程6个月~6年,平均3.4年。术前摄标准腰骶椎侧位X线片,采用PACS影像系统测量骨盆入射角(pelvic incidence,PI)及L4~S1 Cobb角,参照公式[(PI+9°)×70%]计算理想L4~S1 Cobb角;术中矫形过程使用Scoliometer软件测量L4~S1 Cobb角,直至达理想L4~S1 Cobb角±5°范围;术后再次测量L4~S1 Cobb角。比较Scoliometer软件与PACs影像系统测量角度的一致性,以评估该软件测得角度的准确性及可靠性;比较理想L4~ S1 Cobb角分别与手术前后L4~ S1 Cobb角的差值,分析该方法的有效性。 结果术前计算理想L4~S1 Cobb角为(36.17±1.53)°,PACS影像系统测得L4~S1 Cobb角为(22.57±5.50)°;术中矫正后Scoliometer软件测得L4~S1 Cobb角为(32.25±1.46)°;术后PACS影像系统测得L4~ S1 Cobb角为(34.43±1.72)°。术中Scoliometer软件与术后PACS影像系统测量角度比较,组内相关系数为0.96、95%可信区间为(0.93,0.97),提示两者相关性很好;平均绝对误差为1.23°,提示Scoliometer软件与PACS影像系统测量角度有约1.23°的误差范围。理想L4~S1 Cobb角与手术前后PACS影像系统测得的L4~S1 Cobb角绝对差值分别为(13.60±1.85)、(2.31±0.23)°,比较差异有统计学意义(t=6.065,P=0.001)。 结论智能手机Scoliometer软件可辅助医师在L4~S1融合术中获得最优化LL

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