在有无先天性颈椎发育异常的情况下,手术治疗前后患有中牙列比例的青少年躯干姿势平衡失调的情况
- 作者: Nikityuk I.E.1, Botsarova S.A.1,2, Semenov M.G.1,2, Murashko T.V.1, Vissarionov S.V.1,2
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隶属关系:
- H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 11, 编号 4 (2023)
- 页面: 473-486
- 栏目: Clinical studies
- ##submission.dateSubmitted##: 09.10.2023
- ##submission.dateAccepted##: 10.11.2023
- ##submission.datePublished##: 20.12.2023
- URL: https://journals.eco-vector.com/turner/article/view/606640
- DOI: https://doi.org/10.17816/PTORS606640
- ID: 606640
如何引用文章
详细
论证。在颌骨畸形和咬合障碍的患者中,发现颈椎形态异常的患者并不少见。有脊髓传导功能可能受损的患者的隐匿性神经功能异常有希望通过体位平衡受损的程度来评估,而体位平衡障碍程度可通过稳定测量法很好地诊断出来。
本研究旨在评估有无先天性颈椎发育异常的近中牙列比例的青少年在重建下颌手术形成建设性咬合前后的姿势稳定性动态。
材料和方法。该研究对31例15-17岁的牙槽颌面综合畸形和中牙列比例患者进行了临床径向和双平台稳定测量研究。根据多螺旋计算机断层扫描结果,主研究组包括10名患有各种先天性颈椎畸形的青少年。对照组包括21例没有颈椎异常CT征象的患者。研究了这些患者在手术咬合矫正前和矫正后1个月至1年内全身压力中心和对侧下肢压力中心运动的稳定测量参数。
结果。与对照组患者相比,主要治疗组患者在手术治疗前身体姿势平衡失调更为明显。具体表现为:额矢状体位稳定性失调、静态肌电图区域和压力中心线速度病理性增加、对侧下肢之间稳定测量参数的异常高度不对称。咬合矫正手术后,对照组患者体位平衡出现恶化迹象:总压力中心运动方向突然改变的系数从18[15-20]%显著增加到23[15-31]%,对侧下肢压力中心线速度的不对称性从0.9[0.3-1.6]毫米/秒显著增加到2.2[0.9-4.4]毫米/秒。相反,我们在主要组患者身上观察到了积极的动态变化--这些参数朝着正常化的方向转变:系数呈下降趋势,压力中心的速率显著下降。
结论。为了提高对患有先天性牙槽颌面综合畸形的青少年进行综合诊断和医疗康复的质量,需要结合姿势的稳定性和运动学评估,对颈椎进行额外的放射检查。
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作者简介
Igor E. Nikityuk
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: femtotech@mail.ru
ORCID iD: 0000-0001-5546-2729
SPIN 代码: 5901-2048
MD, PhD, Cand. Sci. (Med.)
俄罗斯联邦, Saint PetersburgSofia A. Botsarova
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov
Email: Dr.Botsarova@mail.ru
ORCID iD: 0000-0002-4675-8517
SPIN 代码: 4930-8561
MD, PhD student
俄罗斯联邦, Saint Petersburg; Saint PetersburgMikhail G. Semenov
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov
Email: sem_mikhail@mail.ru
ORCID iD: 0000-0002-1295-1554
SPIN 代码: 2603-1085
MD, PhD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Saint Petersburg; Saint PetersburgTatyana V. Murashko
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: popova332@mail.ru
ORCID iD: 0000-0002-0596-3741
SPIN 代码: 9295-6453
MD, radiologist
俄罗斯联邦, Saint PetersburgSergei V. Vissarionov
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN 代码: 7125-4930
MD, PhD, Dr. Sci. (Med.), Professor, Corresponding Member of RAS
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