Lenke2型青少年特发性脊柱侧凸患者第一胸椎倾斜与双肩美学平衡的相关性研究  

The correlation between T1 tilt and cosmetic shoulder balance in Lenke type 2 adolescent idiopathic scoliosis patients

作　　者：邱旭升[1] 邱勇[1] 蒋军[1] 王斌[1] 朱泽章[1] 钱邦平[1] 俞杨[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,210008

出　　处：《中华外科杂志》2013年第8期728-731,共4页Chinese Journal of Surgery

基　　金：国家自然科学基金资助项目（81171767）;南京市医学科技发展杰出青年基金资助项目（JQX12005）

摘　　要：目的探索青少年特发性脊柱侧凸（AIS）患者第一胸椎（T1）倾斜与双肩美学平衡的相关性。方法选择2010年1月至2011年12月就诊的71例Lenke2型AIS患者进行研究。其中女性61例，男性10例；年龄10～18岁，平均（15．1士2．9）岁；Risser征1—5，平均2．8。患者在自然站立位拍摄后前位照片及进行全脊柱x线检查。在x线片上测量T．倾斜，并在照片上测量内侧美学双肩高度差（CSHi）以及外侧美学双肩高度差（CSHo），CSHi和CSHo统称为CSH。T，向右倾斜为正值，反之为负值。T1倾斜〉5。定义为正性倾斜，T1倾斜〈-5°定义为负性倾斜，-5°≤T，倾斜≤5。定义为T1水平。左肩高于右肩时CSH为正值，反之为负值。CSH〉5mm定义为正性CSH，CSH〈-5mm定义为负性CSH；-5mm≤CSH≤5mm定义为双肩水平。T1倾斜与CSHi、CSHo之间进行Pearson相关分析。结果T，倾斜与CSHi、CSHo之间呈正相关关系（r=0．25和0．28，P〈0．05）。T1正性倾斜患者中，正性CSHo、水平CSHo、负性CSHo患者比例分别为59．0％（36／61）、37．7％（23／61）和3．3％（2／61）；T，水平患者则分别为3／10、5／10和2／10。T1正性倾斜患者中，正性CSHi、水平CSHi、负性CSHi患者比例分别为83．6％（51／61）、11．5％（7／61）和4．9％（3／61）；T，水平患者则分别为6／10、2／10和2／10。结论T，倾斜与双肩美学平衡之间有相关性，但是正性T，倾斜患者可以表现为左肩高，也可以表现为双肩等高或者右肩高。Objective To study the relationship between T1 tilt and cosmetic shoulder balance in adolescent idiopathic scoliosis （AIS） patients. Methods Seventy-one Lenke type 2 AIS patients were recruited into the present study from January 2010 to December 2011. There were 61 female and 10 male patients,the average age was （15.1 2. 9） years （range 10-18 years）; the average Risser sign was 2. 8 （ range 1-5）. The patients were photographed from the back in neutral standing position on level ground wearing underpants. Also, all the patients had a standing posterior-anterior radiograph in a relaxed standing position. The cosmetic shoulder height （CSH）, which included cosmetic inner shoulder height （CSHi） and cosmetic outer shoulder height （ CSHo）, were measured in the photographs. Positive value was defined as left shoulder was higher than the right shoulder, and negative value was defined as right shoulder was higher than the left shoulder. CSH 〉 5 mm was defined as positive CSH, CSH 〈 - 5 mm was defined as negative CSH, -5 mm〈 CSH 〈 5 mm was defined as leveled CSH. Tl tilts were measured in the posterior-anterior radiographs. Positive value was defined as the left proximal vertebral body up and fight lower vertebral body down, and negative value was defined as the right proximal vertebral body up and left lower vertebral body down. T1 tilt 〉5° was defined as positive T1 tilt, T1tilt 〈 -5° was defined as negative Tt tilt, -5 〈T1 tilt〈5° was defined as leveled T° tilt. Results T1 tilt was found to be significantly correlated with CSHi andCSHn （ r =0. 25 and 0. 28,1＇ 〈0. 05 ）. For positive T1 tilt patients, there were 59. 0%, （ 36/61 ） patients witil positive CSH, 37.7% （23/61）with leveled CSHo, and 3.3% （2/61）with negative CSHo. For the palients with lew＇lel 1＇I till, it as 3/10, 5/10 antl 2/10. For positive TI till lmlienls, lhere were 83. 6 （.51/61） patiellls with posilixe CStti, I 1.5c,＋ （ 7/61 ） with leveled CSHi, and 4. 9c/ （ 3/61 ） wit

关 键 词：脊柱侧凸 人体测量术 肩 

分 类 号：R682[医药卫生—骨科学]