轻中度胸弯型青少年特发性脊柱侧凸患者胸椎后凸角对上胸椎后凸角的影响  

Effect of thoracic kyphosis on upper thoracic kyphosis in patients with mild and moderate thoracic adolescent idiopathic scoliosis

作　　者：赵清华[1] 朱泽章[1] 邱勇[1] 王斌[1] 钱邦平[1] 朱锋[1] 蒋军[1] 毛赛虎[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,江苏省南京市210008

出　　处：《中国脊柱脊髓杂志》2011年第6期463-467,共5页Chinese Journal of Spine and Spinal Cord

基　　金：江苏省人事厅六大人才高峰项目(编号:07-B-027)

摘　　要：目的：探讨轻中度胸弯型青少年特发性脊柱侧凸（adolescent idiopathic scoliosis,AIS）患者胸椎后凸角与上胸椎后凸角的关系,并评估其临床意义。方法：选取在我院就诊的轻中度（Cobb角40°60°）单胸弯型AIS患者50例、双胸弯型AIS患者50例,均摄站立位脊柱全长正位X线片及上肢抱胸体位下的站立位脊柱全长侧位X线片。测量主胸弯Cobb角、上胸椎（T2T5）后凸角（upper thoracic kyphosis,UTK）及胸椎（T5T12）后凸角（total kyphosis,TK）。两种弯型患者分别按TK大小分为两组：A组TK〈10°,B组10°≤TK≤40°。分别将两种弯型的A组及B组的参数测量结果进行比较,并对相关参数指标进行Spearman相关分析。结果：在单胸弯型AIS患者中,A组UTK平均为6.9°,B组为9.8°,两组比较有统计学意义（P〈0.05）;单胸弯AIS患者TK与UTK存在显著性正相关（P〈0.05）。在双胸弯型AIS患者中,A组的UTK平均为12.0°,B组为11.9°,两组比较无统计学差异（P〉0.05）,双胸弯型AIS患者的TK与UTK无显著性相关（P〉0.05）。结论：双胸弯型AIS患者的TK对UTK无明显影响;而单胸弯型AIS患者的UTK会随着TK的减小而减小,在对单胸弯型AIS患者进行胸椎融合时,应考虑其对术后矢状面形态重建的影响。Objective：To evaluate the effect of thoracic kyphosis on upper thoracic kyphosis in thoracic curve type of adolescent idiopathic scoliosis（AIS）.Method：100 cases with AIS in our database which included 50 single thoracic curve and 50 double thoracic curves were reviewed.According to the thoracic kyphosis（TK）,all cases were divided into two groups：group A with TK〈10° and group B with 10°≤TK≤40°.Based on standing posteroanterior and lateral X-rays,the following parameters were measured： Cobb angle of main thoracic curve,upper thoracic kyphosis（T2-T5）,thoracic kyphosis（T5~T12）.The above parameters between two groups were analyzed by using t-test,and linear correlation between parameters were calculated by Spearman correlation coefficients.Result：For single thoracic curve,the upper thoracic kyphosis in group A was smaller than that in group B（6.9° versus 9.8°,P 〈0.05）.Significant linear correlation was found between thoracic kyphosis and upper thoracic kyphosis in both subgroups（P〈0.05）.For double thoracic curves,no significant difference was found betweent two subgroups（12.0° versus 11.9°,P〉0.05）,and no significant correlation was found between thoracic kyphosis and upper thoracic kyphosis（P〉0.05）.Conclusion：The thoracic kyphosis may not influence the upper thoracic kyphosis in AIS patients with mild and moderate double thoracic curves,while the upper thoracic kyphosis decreases with decreasing of the thoracic kyphosis,which should be taken into consideration for sagittal realignment with posterior thoracic fusion in mild and moderate thoracic AIS pa-tients.

关 键 词：青少年特发性脊柱侧凸 胸弯型 上胸椎后凸角 胸椎后凸角 

分 类 号：R682.3[医药卫生—骨科学]