基于三维图像体积融合技术的青少年特发性脊柱侧凸脊柱在体运动特点研究  

Research on in vivo kinematics characteristics of the spine in adolescent idiopathic scoliosis patientsbased on 3D image volume fusion technique

作　　者：陆维[1] 陈家瑜[1] 王龙[1] 王均[2] 罗浩天[1] 王少白 陆声[1] 徐永清[1] 

机构地区：[1]解放军昆明总医院骨科,昆明医科大学解放军昆明总医院临床学院,650032 [2]昆明医科大学第一附属医院老年骨科,650000 [3]上海逸动医学科技有限公司,201615

出　　处：《中华创伤骨科杂志》2017年第4期311-316,共6页Chinese Journal of Orthopaedic Trauma

基　　金：云南省科技计划重点项目（2014FA049）

摘　　要：目的利用三维图像体积融合技术研究Lenke1型青少年特发性脊柱侧凸（AIS）脊柱在支点侧屈位下六自由度（6DOF）运动特点°方法对10名Lenke1型AIS志愿者利用宝石cT分别获取平卧位及支点侧屈位T°至S°的平扫数据°将数据导入三维建模软件建立各椎体的模型及坐标系°利用计算机软件将2种不同体位的图像进行3D图像体积融合，获得目标区域内各椎体间的在体运动学数据°结果支点侧屈位下，顶椎（AV）区域：各节段主运动旋转范围为-2．57°±0．95°至-1．37±°±0．65°，各节段间比较差异有统计学意义（p〈0．05）；沿垂直轴的耦合旋转范围为-2．71°±0．48°至-1．270±0．490，沿冠状轴的耦合屈伸范围为0．19°±O．85°至1．51°±0．42°上端椎（UEV）区域：各节段主运动旋转范围为-1．910±0．76°至-2．20°±1．13°，3节段间比较差异无统计学意义（P〉0．05）；沿垂直轴的耦合旋转范围为0．18°±0．47°至1．35°±0．52°，沿冠状轴的耦合屈伸范围为1．62°±0．41°至2．07°±0．37°下端椎（LEV）区域：各节段在主运动旋转范围为-0．79°±0．63°至0．73°±1．09°，3节段间比较差异有统计学意义（P〈0．05）；沿垂直轴的耦合旋转范围为-1．62°±1．050至-0．60°±0．60°，沿冠状轴的耦合屈伸范围为-1．41°±0．87°至-0．75°±0．66°结论支点侧屈位下，Lenke1型AIS脊柱各关键椎体区域均有其独特的运动及耦合机制；UEV区域耦合旋转运动方向为侧屈运动的同侧；AV和LEV区域耦合旋转运动方向为侧屈运动的对侧，Objective To characterize the spinal motion of 6 degrees of freedom （6DOF） under the fulcrum bending in Lenke type 1 adolescent idiopathic scoliosis （AIS） patients using 3D image volume fusion technique. Methods Ten volunteers with Lenke type 1 AIS were examined by the Gemstone Spectral Imaging to obtain their T1-S1 vertebral morphological data in the supine position and fulcrum bending position. With the computer software, images of 2 different positions were fused with the 3D image to obtain in vivo kinematics data of each vertebral body in the target area. Results In the apical vertebrae （AV） region, the main range of motion in the fulcrum bending position ranged from -2.57°± O. 95° to - 1. 37°± 0. 65°, showing significant differences between segments （ P 〈 0.05） ; along the vertical axis the coupling rotation ranged from -2.71± 0. 48° to - 1.27° ± 0. 49°; along the coronal axis, the coupling flexion and extension ranged from 0. 19± 0. 85 ° to 1.51 °± 0. 42°. In the upper end vertebrae （UEV） area, the main ROM ranged from - 2. 20° ± 1.13° to - 1.91°± 0. 76°, showing no significant differences between the 3 segments （ P 〉0. 05）; along the vertical axis, coupling rotation ranged from 0. 18°± 0.47° to 1.35°± 0.52°; along the coronal axis, coupling flexion and extension ranged from 1.62°± 0. 41° to 2. 07°± 0. 37°. In the lower end vertebrae （LEV） region, the main movement ranged from - 0. 79° ± 0. 63° to 0.73° ± 1.09°, showing sig- nificant differences between the 3 segments （ P 〈 0. 05） ; along the vertical axis, the coupling rotation ranged from - 1.62°± 1.05Q to -0. 60°± O. 60°; along the coronal axis, the coupling flexion extension ranged from - 1.41° ± 0. 87° to - O. 75° ±0.66°. Conclusions In the fulcrum bending position, Lenke type 1 AIS shows a unique motion and coupling mechanism in the spine. The coupling rotational movement in the UEV region is at the same side as the lateral flexion movement. The coupling rotation

关 键 词：脊柱侧凸 成像 三维 活动范围 关节 青少年 

分 类 号：R726.8[医药卫生—儿科]