特发性脊柱侧弯患者躯干倾斜角与脊柱Cobb角、冠状面平衡的相关性研究

目的:研究单胸腰弯特发性脊柱侧弯患者的躯干倾斜角与脊柱Cobb角、冠状面平衡的相关性,为明确脊柱形变与躯干外观畸形的关系提供理论基础。方法:在前期的脊柱侧弯筛查中,选取符合要求的患者40例,其中男性5例,女性35例。使用Scoliometer测量患者的躯干倾斜角(ATI);选取患者近一个月的脊柱全长X光片,测量Cobb角、C7椎体垂直线与骶骨中垂线之间的距离(C7PL-CSVL)、顶椎偏离骶骨中垂线的距离(AVT),并分析ATI与Cobb角、C7PL-CSVL和AVT之间的相关性。结果:ATI角与Cobb角之间有相关性(r=0.702,P<0.01),ATI角的增加可表示Cobb角的增加,此相关性适用于单胸腰弯AIS患者;ATI角与C7PL-CSVL间的差异无统计学意义(r=0.294,P>0.05);ATI角与AVT之间有相关性(r=0.499,P<0.01)。结论:在单胸腰弯AIS患者中,躯干的外观畸形程度可以反映脊柱畸形的程度;在AIS患者的诊治过程中,可将ATI角作为评估指标来量化与监测躯干外观畸形程度。

Correlation of trunk inclination angle with Cobb angle and coronal plane balance in idiopathic scoliosis

Objective:To study the correlation of trunk inclination angle(ATI)with Cobb angle and coronal plane balance in patients with idiopathic scoliosis of single thoracic and lumbar spine,so as to provide theoretical basis for clarifying the relationship between spinal deformation and trunk deformity.Methods:In the early stage of scoliosis screening,40 patients who met the requirements were selected,including 5 males and 35 females.Scoliometer was used to measure the ATI of the patients.On the spine X-ray films performed less than one month ahead of the study,the Cobb angle,offset between central sacral vertical line(CSVL)and C7 vertebra plumb line(C7PL)(C7PL-CSVL),and apex vertebral translocation(AVT)were measured,and the correlation between ATI and Cobb angle,and between C7PL-CSVL and AVT was analyzed.Results:It was found that there was a significant correlation between ATI angle and Cobb angle(r=0.702,P=0.000),and the increase of ATI angle could indicate the increase of Cobb angle.This correlation was applicable to patients with AIS with single-thoracic lumbar curvature.There was no significant difference between ATI angle and C7PL-CSVL(r=0.294,P=0.065).There was a correlation between ATI angle and AVT(r=0.499,P=0.001).The ATI angle was related to the partial imbalance of the coronal plane of the spine.Conclusion:In patients with single thoracolumbar AIS,the apparent deformity of the trunk can reflect the deformity of the spine.In the diagnosis and treatment of AIS patients,ATI angle can be used as an evaluation index to quantify and monitor the deformity of trunk appearance.