不同体位对青少年特发性脊柱侧凸的腰椎前凸改变的影响

目的观察单胸弯青少年特发性脊柱侧凸（T—AIS）患者和单腰弯AIS（L—AIS）患者的腰椎前凸（LL）在平卧位下的改变，量化评估平卧位对LL的影响，并评估站立位冠状面腰弯是否影响平卧位LL的变化趋势。方法回顾性分析2010年1月—2012年12月南京大学医学院附属鼓楼医院行手术治疗的女性AIS患者的临床资料，其中T—AIS50例，L—AIS44例。T—AIS患者的平均年龄为（14．95±2．82）岁，术前平均Cobb角为47．19°±10．43°；L—AIS患者的平均年龄（15．22±2．28）岁，术前平均Cobb角为48．12°±9．29°，两组患者的年龄及Cobb角的差异均无统计学意义（t=0．506、P=0．614及t=0．439、P=0．661）。脊柱侧凸患者存在支具治疗史，神经肌源性疾病、内分泌紊乱、骨骼发育不良、神经系统异常、结缔组织病或智力异常均被排除。所有患者均在术前摄站立位全脊柱侧位X线片及平卧位腰椎侧位X线片。在站立位及平卧位侧位X线片上测量LL。采用Pearson相关性分析分别分析T—AIS和L—AIS患者站立位和平卧位LL的相关性；分别对T—AIS和L—AIS患者站立位和平卧位LL的差值（△LL）进行一般统计学分析，并使用独立样本t检验评估两组患者站立位LL、平卧位LL及ALL之间的差异。以P〈0．05为差异有统计学意义。结果T—AIS患者的站立位LL为50．49°±8．73°，显著大于平卧位状态下的40．79°±9．89°（t=5．199，P〈0．01）；L—AIS患者的站立位LL（51．95°±13．49°）和平卧位LL（36．37°±11．82°）的差异有统计学意义（t=5．762，P〈0．01）。虽然两组患者问站立位LL的差异（t’=-0．614）和平卧位LL（t=1．974）的差异均无统计学意义（P值均〉0．05），但是L-AIS患者的ALL（9．70°±9．34°）大于T—AIS患者的ALL（15．58°±12．42°），差异有统计学意义（t=2．613，P=0．011）。Person相关性分析显示，T—AIS和L?

The influence of supine position on lumbar lordosis in adolescent idiopathic scoliosis with or without lumbar curve

Objective To quantify the influence of supine position on lumbar lordosis and to evaluate whether lumbar curve would affect the change of lumbar lordosis from standing position to supine position. Methods Fifty female thoracic adolescent idiopathic scoliosis （T-AIS） patients and forty-four female lumbar adolescent idiopathic scoliosis （L-AIS） patients were collected in Spine Surgery of the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2010 to December 2012. The dataes of these patients were retrospectively reviewed in this study. The mean age of T-AIS patients was （ 14.95 ± 2.82 ） years and the Cobb angle averaged 47.19° ± 10.43°. While in L-MS patients, the age averaged （ 15.22 ± 2.28 ） years and Cobb angle 48.12°±9.29°. No difference was found in terms of age and Cobb angle （t =0. 506, P = 0. 614, t = 0. 439, P = 0. 661 ）. Patients with history of brace treatment neuromuscular disease, osteopenia, neurological disorders, endocrine disorders, connective tissue diseases or abnormal intelligence were excluded. The long-cassette standing radiographies and lumbar X-ray lateral films in supine position were obtained from all subjects. Lumbar lordosis （LL） was measured on both standing and supine films. The relationship between standing LL and supine LL was calculated by Pearson correlation in both T-AIS and L-AIS groups. The differences in terms of standing LL, supine LL and ALL were also analyzed through independent t test. Statistically significant differences were defined by P 〈 0.05. Results The standing LL averaged in T-AIS group, which was significantly larger than supine LL in the same group （50.49°±8.75° vs. 40.79°± 9.89°, t = 5. 199, P 〈 0.01 ）. Similarly, significant difference was also observed in L-AIS group （51.95°±13.49° vs. 36.37°± 11.82°, t =5.762, P〈0.01）. According to Pearson correlation, strong correlations were observed between standing LL and supine LL in both T-AIS and L-AIS groups（r =0. 683, r =0. 778