特发性胸椎左侧凸患者的临床及影像学特征

目的探讨特发性胸椎左侧凸患者的临床及影像学特征。方法通过对病史、查体、X线、全脊髓MRJ等检查，回顾性分析11例特发性胸椎左侧凸患者（A组）的临床资料，测量冠状面及矢状面影像学参数，并将相关指标与特发性胸椎右侧凸患者（B组）进行比较分析。结果特发性胸椎左侧凸以男性多见，男：女为7：4。11例患者弯型分布为：三弯1例，双弯（胸主弯／代偿性腰弯）2例，单胸弯8例。主弯的上端椎分布于T5-T8，下端椎分布于T11～L3，平均跨度达7．1＋1．4节，顶椎分布于T8～T11，单胸弯（75％）型患者中6例顶椎位于T9。与右侧凸型相比，特发性胸椎左侧凸型患者胸椎后凸角（T5-T12）较大（31．20±21．8°VS12．8°±9．4°），差异有显著统计学意义（P〈0．01），其余影像学参数两组间比较均无统计学差异。结论特发性胸椎左侧凸患者影像学上具有一定的特征性：在冠状面上，特发性胸椎左侧凸的侧凸模式与右侧凸型相似，呈“镜像”模式；但在矢状面上，特发性胸椎左侧凸型患者胸椎后凸角趋于正常，甚至呈过度后凸，与右侧凸型不同。

Clinical and radiological characteristics in idiopathic left thoracic scoliosis patients with a Cobb angle greater than 40 degree

Objective To investigate the clinical and radiological features in idiopathic left thoracic seoliosis patients with a Cobb angle greater than 40 degree. Methods The clinical data of 11 consecutive idiopathic left thoracic scoliosis patients were retrospectively reviewed. The coronal and sagittal radiographic parameters were obtained and compared with those of idiopathic right thoracic scoliosis patients. Results Despite the habitual predominance of idiopathic scoliosis in female, there was a large male predominance in our series. The male： female ratio was 7：4. Of the total 11 cases, three curve patterns were identified as follows： a triple-curve pattern （1 case）, a double-curve pattern （major thoracic/compensatory lumbar curve） （2 cases）, and a single-curve pattern （8 cases）. The upper end vertebrae of the major curve varied from T5 to T8, and the lower end vertebrae of the same curve was from Tll to L3. The mean involved segment of the major curve was 7.1±1.4. The location of thoracic apex was between T8-T11. The T9 location was the apex of 6 single thoracic curve cases. The degree of thoracic kyphosis（T5-T12） was higher in patients with idiopathic left thoracic scoliosis patients than in controls （31.2°±21.8°vs 12.8°±9.4°, P〈0.01）. Conclusion The idiopathic left thoracic scoliosis patients show distinctive imaging characteristics. On the coronal plane, the curve pattern of idiopathic left thoracic scoliosis is the mirror image of that of idiopathic fight thoracic scoliosis. However, on the sagittal plane, the profile of the idiopathic left thoracic scoliosis varies from that of idiopathic right thoracic scoliosis.