청소년기 특발성 척추측만증에서 체위 및 마취에 따른 변형의 변화

국문 초록 (Abstract)

목적: 척추측만증에서 관상면상 및 축면상 변형의 크기와 끝 척추, 중립 척추가 체위 및 마취에 의해 어떻게 변화하는지 알아보았다.
대상 및 방법: 31명의 특발성 척추측만증 환자에서 62개의 구조성 만곡을 대상으로 기립, 앙와위, 측 굴곡, 마취 후, 술후 전후면 단순 방사선사진상 각 만곡의 Cobb 각과 Perdriolle의 방법에 의한 첨부 척추의 회전 변형을 측정하고, 기립, 앙와위, 마취 후 방사선사진에서 끝 척추, 중립 척추를 확인하여 서로 비교하였다.
결과: 앙와위, 측 굴곡, 마취, 수술에 의해 술전 기립 방사선사진상의 Cobb 각은 각각 25.0%, 59.5%, 31.7%, 74.0%가 교정되었으며, 회전각은 각각 6.1%, 6.2%, 24.5%, 25.7%가 교정되었다. 앙와위 및 마취 후 사진 모두에서 18명(58.1%)의 환자가 끝 척추의 변이를 보였고, 중립 척추는 앙와위 사진에서 10명(32.3%), 마취 후 사진에서 20명(64.5%)이 변이를 보였다.
결론: 측만증의 관상면상 변형은 앙와위 자세 및 마취에 의해 상당 부분 교정된다. 회전 변형은 마취에 의해 유의하게 교정되며, 강봉 반회전술로 그 이상의 교정을 얻을 수 없다. 끝 척추 및 중립 척추 또한 앙와위 자세 및 마취에 의해 변화하는 경우가 많기 때문에 유합 범위의 결정에 혼란을 초래할 수 있다.

다국어 초록 (Multilingual Abstract)

Purpose: To determine changes in the end vertebra and neutral vertebra as well as in the magnitudes of coronal and rotational deformities according to position and anesthesia in patients with adolescent idiopathic scoliosis.
Materials and Methods: Sixty-two structural curves in 31 patients were evaluated using standing, supine, side bending, post-anesthesia, and postoperative anteroposterior plain radiographs. Cobb angles and rotation angles by perdriolle torsionmeter were measured, and the end vertebra and neutral vertebra were identified in each radiograph.
Results: Coronal cobb angles decreased significantly with correction rates of 25.0%, 31.7%, 59.5%, and 74.0%, and rotational deformities decreased with correction ratesof 6.1 %, 24.5%, 6.2%, and 25.7% by supine position, anesthesia, side bending and surgery, respectively. The end vertebrae changed in 18 patients (58.1%) in both supine and post-anesthesia radiographs, and the neutral vertebrae changed in 10 patients (32.3%) in supine radiographs and in 20 patients (64.5%) in post-anesthesia radiographs.
Conclusion: Coronal deformities are significantly corrected by supine position and anesthesia. Anesthesia significantly corrects axial rotation, but more correction cannot be achieved by rod derotation. The end vertebra and neutral vertebra have a tendency to vary by position and anesthesia, which gives rise to confusion in the determination of fusion level.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• 참고문헌
• 국문초록

참고문헌 (Reference)

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