正常青少年及青少年特发性脊柱侧凸患者枕颈部矢状面形态相关研究

目的比较正常青少年与青少年特发性脊柱侧凸（AIS）患者枕颈矢状面形态，探讨其枕颈矢状面形态与颈椎矢状面形态相关性。方法收集2012年3月—2014年3月在南京鼓楼医院脊柱外科入院治疗并符合入选标准的AIS患者80例（男14例，女66例）作为AIS组；正常青少年志愿者100名（男17名，女83名）作为对照组。在枕颈部侧位X线片上测量并记录枕骨入射角（OI）、枕骨斜率（OS）、枕骨倾斜角（OX）、上颈椎前凸角（C0-C2）、下颈椎前凸角（C2-C7）和颈椎前凸角（C0-C7），比较对照组与AIS组枕颈参数差异及其与年龄、性别的关系，并分析枕颈参数与颈椎矢状面形态相关性。结果对照组OI、OS和OT分别为36．12°±2．55°（30°～44°）、26．34°±8．41°（15°-46°）和-10．06°±7．51°（-22°～11°），AIS组OI、OS和OT分别为35．62°±3．01°（31°～42°）、24．27°±8．49°（7°-42°）和-11．52°±9．23°（-28°-10°），两组枕颈部形态参数差异均无统计学意义（t分别为0．878、1．014、1．306，P值均〉0．05），且不受年龄（≤14岁，〉14～18岁）、性别影响（P值均〉0．05）。对照组OI与C0-C2角和C0-C7角显著相关（r=0．307和r=0．298，P值均〈0．05），OS和OT分别与C2-C7角和C0-C7角显著相关（r=0．402和r=0．560、r=0．428和r=0．550，P值均〈0．05）；而AIS组仅OI和OS与C0-C2角存在显著相关性（r=0．532和r=0．620，P值均〈0．05）。结论正常青少年和AIS患者的枕颈参数无显著差异，且不受年龄与性别影响。正常青少年OI、OS和OT与颈椎矢状面形态显著相关，而AIS患者枕颈部矢状面形态仅与其上颈椎矢状面形态密切相关。

Occipitocervical sagittal alignment in normal adolescents and adolescents with idiopathic scoliosis

Objective To compare the occipitocervical sagittal alignment in normal adolescents and age- and gender-matched patients with adolescent idiopathic scoliosis （AIS） and analyze the relationship between occipitocervical parameters and cervical sagittal balance. Methods A total of 100 adolescent volunteers and 80 patients with AIS at the Affiliated Drum Tower Hospital of Nanjing University Medical School from March 2012 to March 2014 were recruited. Occipital incidence （OI）, occipital slope （OS） , occipital tilt （ OT）, C0-C2 angle, C2-C7 angle and C0-C7 angle were measured on sagittal occipitocervical image. The occipitocervical parameters were compared between the two groups and the relationship with age and gender was further evaluated. Correlations between occipitocervical parameters and cervical sagittal alignment in two groups were analyzed with Pearson coefficient. Results The mean OI, OS, OT were 36.12°± 2.55° （30°-44°）, 26.34° ± 8.41° （15°-46°）, -10.06°± 7.51° （ -22°-11°） in normal group and 35. 62°± 3.01° （31°-42°）, 24.27°± 8.49° （7°- 42°）, -11.52°± 9.23° （ -28° -10°） in AIS group, respectively. Occipitocervical parameters in two groups were not significantly different （ t = 0. 878, t = 1. 014, t = 1. 306, all P values 〉 0.05 ）. Furtherly, no significant differences were noted between males and females, or between younger （ ≤ 14 years） and older subjects （ 〉 14 years） （all P values 〉 0.05 ）. Significant correlations were observed between OI and C0-C2 angle （r = 0.307, P 〈 0.05 ）, OI and C0-C7 angle（r =0. 298, P 〈0.05）, OS and C2-C7 angle（r =0. 402, P 〈0.05）, OS and C0-C7 angle（ r = 0. 560, P 〈 0. 05 ）, OT and C2-C7 angle （ r = 0. 428, P 〈 0.05 ） and OT and C0-C7 angle （ r = 0. 550, P 〈 0. 05 ） in normal group. However, only the correlations between OI and C0-C2 angle （r = 0. 532, P 〈0.05）, OS and C0-C2 angle（r =0.620, P 〈0.05） were significant in AIS group. Conclusions