主胸弯型青少年特发性脊柱侧凸患者脊柱——骨盆整体矢状位序列的相关性研究  

Study on the correlation with the whole spine-pelvis sagittal sequence changes of Lenke 1 AIS in adolescence

作　　者：朱旭[1] 代杰[1] 眭江涛 谢江[1] 马原[1] ZHU Xu;DAI Jie;SUI Jiang-tao;XIE Jiang;MA Yuan(Department of spine surgery,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi,830000,China)

机构地区：[1]新疆医科大学第六附属医院脊柱外科,乌鲁木齐市830000

出　　处：《新疆医学》2020年第9期883-886,共4页Xinjiang Medical Journal

基　　金：国家自然科学基金(项目编号:81760411)。

摘　　要：目的整理分析32例主胸弯型青少年特发性脊柱侧凸(Lenke 1型AIS)患者术前影像学资料,探索该类型患者脊柱-骨盆整体矢状位序列的相关性。方法Lenke 1型AIS患者拍摄站立位全脊柱站立位正侧位X线片以及左右侧屈位片(Bending位片),测量并记录站立位及Bending位冠状位Cobb角、颈椎矢状位曲度(C2-C7 Cobb角)、胸椎后凸角(T5-T12 Cobb角,TK)、腰椎前凸角(L1-L5 Cobb角,LL)、骨盆参数:骨盆入射角(Pelvic Incidence,PI)、骶骨倾斜角(Sacrum Slop,SS)、骨盆倾斜角(Pelvic Tilt,PT)、C7-S1及C2-C7 SVA(Sagittal Vertical Axis)、胸1倾斜角(T1 slope),选取30例健康青少年拍摄站立位全脊柱全长正侧位片测量颈椎矢状位曲度(C2-C7 Cobb角),分析两变量Pearson相关性分析及t检验作为统计方法分析统计学差异。结果本组侧凸患者与健康青少年相比,C2-C7 Cobb角显著性增大(P<0.05)。Lenke 1型AIS患者中颈椎后凸组,T5-T12 Cobb角显著降低(P<0.05),胸椎后凸角度C2-C7 Cobb角显著增大(P<0.05)。C2-C7 Cobb与T5-T12 Cobb角呈负相关(P=0.008),与L1-L5 Cobb角呈正相关(P=0.005)。C2-C7 Cobb角与冠状位Cobb角度、PI、SS、PT、C7-S1 SVA未见相关性(P>0.05)。结论Lenke 1型AIS患者颈椎矢状位序列异常者高于正常青少年组,颈椎矢状位序列与TK、T1 slope,而与胸腰椎冠状位角度及骨盆参数无关。Objective To analyze the imaging data of 32 cases of adolescent idiopathic scoliosis(Lenke 1 type AIS)with major thoracic curvature and to explore the changes of the whole spine pelvis sagittal sequence.Methods X-ray films and bending films were taken in standing position,and coronal Cobb angle,sagittal cervical curvature(C2-C7 Cobb angle),thoracic kyphosis angle(T5-T12 Cobb angle,TK)and lumbar lordosis angle(L1-L5 Cobb angle)were measured and recorded.Pelvic parameters including pelvic incidence(PI),sacral slope(SS),pelvic tilt(PT),C7-S1 and C2-C7 SVA(sagittal vertical axis)were measured.The sagittal cervical curvature(C2-C7 Cobb angle)was measured by full-length anteroposterior and lateral radiographs among 30 healthy adolescents.Pearson correlation analysis and t-test were used to analyze the statistical differences.Results C2-C7 Cobb angle was significantly increased in scoliosis patients compared with healthy adolescents(P<0.05).The T5-T12 Cobb angle was significantly decreased in the cervical kyphosis group(P<0.05),and the thoracic kyphosis angle C2-C7 was significantly increased(P<0.05).C2-C7 Cobb was negatively correlated with T5-T12 Cobb angle and positively correlated with L1-L5 Cobb angle.There was no correlation between C2-C7 Cobb angle and coronal Cobb angle,PI,SS,PT,C7-S1 SVA(P>0.05).Conclusion The abnormal sagittal sequences of cervical spine in patients with lenke-1 AIS are more than that of normal adolescents,and most of them are kyphosis.The sagittal sequence of cervical spine is related to thoracic kyphosis angle and thoracic-1 inclination angle,but has no realtionship with thoracolumbar coronal angle and pelvic parameters.

关 键 词：主胸弯型青少年特发性脊柱侧凸 颈椎矢状位序列 脊柱-骨盆矢状位序列 

分 类 号：R681.5[医药卫生—骨科学]