青少年特发性脊柱侧凸脊柱-骨盆矢状面形态的性别差异  

Gender dimorphism of spino-pelvic alignment in patients with adolescent idiopathic scoliosis

作　　者：王渭君[1] 王智伟[1] 刘臻[1] 朱泽章[1] 朱锋[1] 王斌[1] 邱勇[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,南京210008

出　　处：《中国矫形外科杂志》2012年第23期2165-2168,共4页Orthopedic Journal of China

基　　金：国家自然科学基金青年基金项目(编号:81101335)

摘　　要：[目的]比较男性和女性AIS患者脊柱及骨盆矢状面形态的差异,探讨AIS患者自然史性别差异的可能原因。[方法]研究收集48例男性和104例女性AIS患者的站立位、侧位X线片。所有患者均未经治疗且需要手术矫形。在侧位X线片上测量胸椎后凸(thoracic kyphosis,TK)、胸腰段后凸(thoracolumbar kyphosis,TL)、腰椎前凸(lumbar lodorsis,LL)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)及骨盆投射角(pelvic inci-dence,PI)。采用成组t检验比较两组间的差异,并用Peason相关分析骨盆参数和脊柱参数间的相关性。[结果]两组患者年龄、骨龄、侧凸类型及严重性无明显差异。女性AIS患者TL及PI分别为(3.0±10.4)°和(45.2±11.0)°,男性患者则分别为(-0.9±10.5)°和(41.4±11.7)°,两组间差异有统计学意义(P<0.05)。两组患者的TK、LL、PT和SS均无统计学差异。两组患者的PI均与PT、SS、TL和LL显著相关,TK与LL相关性有统计学意义(P<0.05)。[结论]男性AIS患者的PI值明显低于女性,表明两者可能存在不同的生长发育模式;男性患者的TL较女性患者低,提示女性AIS胸腰段的稳定性可能较男性患者差。这些差异均可能与AIS侧凸进展的性别差异有关。[ Objective] To investigate the gender dimorphism of spino- pelvic alignment in patients with adolescent idio- pathic scoliosis （AIS） and to analyze whether the differences were involved in the sexual dimorphism of curve progression in AIS. [ Methods] Forty -eight male and 104 female AIS patients who need surgical correction were enrolled in the present stud- y. None of them had previous treatment for the spinal deformity. On the lateral standing radiographs, thoracic kyphosis （TK）, thoracolnmbar kyphosis （TL）, lumbar lordosis （LL）, lumbar tilt （LT）, sacral slope （SS）, pelvic tilt （PT） and pelvic inci- dence （PI） were evaluated. The measurements were compared between male and female AIS by students＇t test. The correlation between spinal parameters and pelvic parameters were analyzed by Pearson correlation analysis. [ Results ] Patients in two groups showed no significant difference on chronological age, Risser grade, curve pattern and severity. Significant differences be- tween two groups were found in TL and PI （ P 〈 0. 05 ）, which were （ 3.0 ± 10.4） ° and （45.2 ± 11.0） ° respectively in female AIS, and were （ - 0. 9 ± 10. 5 ） ° and （41.4 ± 11.7 ）° respectively in male AIS patients. However, there was no significant difference in terms of TK, LL, PT and SS between two groups. In both male and female AIS patients, the PI showed significant correlation with PT, SS, TL and LL, while TK showed significant correlation with LL （P 〈 0. 05） . [ Conclusion] The signifi- cantly lower PI found in male AIS patients compared to the female patients indicated that there might be different growth patterns between male and female AIS patients. In addition, the more kyphotic TL in female AIS implied a lower stability in this region than that of male AIS patients. All these differences may play roles in the gender dimorphism of curve progression in patients with AIS.

关 键 词：特发性脊柱侧凸 骨盆投射角 性别 侧凸进展 

分 类 号：R687.3[医药卫生—骨科学]