脊柱側彎背架之新式取模法

Abstract

脊柱側彎矯治背架是治療脊柱側彎常用的方法之一。雖然臨床上有多種脊柱側彎 矯治背架可供選擇，但由於每一位脊柱側彎患者的脊柱側彎軌跡及其彎曲或旋轉角度 的大小都不盡相同，因此無論是那一型的矯正背架其製作通常需經由個別取模量製而 成。為了達成有效的治療，這些矯治背架需具備下列兩個特性：第一、針對整個脊柱 之側彎與旋轉，背架應有一正確的反方向力道，這點需要矯具師運用正確之生物力學 知識來施力方才可達成；第二、需達到舒適之境界，這樣方能要求患者完全服從醫療 團隊之囑咐，天天穿矯治背架23 小時。然而在以往的經驗裡，取模過程中患者有採坐 姿者也有採躺姿者，且絕大部份需靠矯具師的雙手施加適當的壓力於患者軀幹的適當 部位，以期製作出有效且合身的矯治背架，但事實上常常事與願違，因為過去這些取 模方式太過於依賴人工，而人工製作過程難免會產生較大的誤差。因此本研究發明一 套取模裝置來製作更完美舒適的脊柱側彎矯治背架，亦即是利用氣壓方式進行患者矯 正背架之取模裝置，致使該矯正背架係完全依照患者身體曲線製作完成，進而讓患者 在穿戴時達到均壓、舒適的效果。用這一套新的取模裝置為五名脊柱側彎的病患製做 矯治背架，讓他們每天穿著23 小時，經過半年後，再用X 光檢測他們的脊柱，結果 發現除了其中一名患者脊柱側彎角度未變之外，其餘四名之側彎角度均變小，此外， 主觀上他們五位都覺得新背架十分合身而且舒適，初步看來，此種新型取模裝置確實 可以製作出更完美舒適的脊柱側彎背架，因此值得推廣。

Spinal orthoses are commonly used among the scoliosis patients. Because of the great individual variations between the different scoliosis patients, custom-molded methods are the best way for manufacturing the scoliosis orthoses. Each custom-molded orthosis is necessary to match the following requirements: (1) presenting right corrective derotating force; (2) having comfortable fit, which may improve patients’ compliance. However, there is not any spinal orthosis through many previous casting methods including sitting casting frame or traction casting machine, because most of them are dependent on the skillful techniques of the orthotists. So the purpose of our research is to develop a new casting design, of which both the spinal traction and air-compression design are used. It is seemed to be less dependent on handy orthotists, but more objective. Through this new casting method, the scoliotic spinal orthosis will get more even pressure distribution and fit better than before.Using this new casting method,spinal orthoses were made for five scoliosis patients. After using those new spinal orthoses for six months, followed-up X-ray revealed imporved Cobb’s angle except one patient. Besides, all of them felt fit and comfortable subjectively. Conclusively this new casting method for scoliotic spinal orthosis is valuable.