特发性脊柱侧凸Cobb's角与顶椎多变量旋转畸形的相关性

背景特发性脊柱侧凸是一种三维畸形,目前对其外观表现与畸变的内在规律所知甚少.目的探讨特发性脊柱侧凸Cobb's角与顶椎多变量旋转畸形之间的内在规律.设计采用非随机对照的回顾性研究.地点和对象研究地点为哈尔滨医科大学附属第二医院骨科,研究对象为特发性脊柱侧凸患者37例,男21例,女16例;年龄9～32岁.方法行脊柱正位X线摄片测量侧凸的Cobb's角及顶椎CT扫描测量顶椎的旋转角度(Aaro法)和双侧椎根轴心线与椎体轴心线夹角.主要观察指标正位X线摄片Cobb's角,CT片顶椎旋转角度及双侧椎弓根与椎体轴心角度.结果在38°～124°内,侧凸Cobb's角每增加1°,顶椎旋转增加0.39°.凸凹侧顶椎椎弓根轴心线与椎体轴心线夹角分别为(4.72±6.02)°,(14.22±6.52)°.结论特发性脊柱侧凸Cobb's角与顶椎旋转之间有明显的内在联系和线性关系,双侧顶椎椎弓根与椎体轴心角度有显著差异.

Relationship between Cobb's angle of idiopathic scoliosis and multivariable rotation deformity of top vertebrae

BACKGROUND: Idiopathic scoliosis(IS) is a kind of three-dimensional deformity. At present, little is known about the outward appearance and the inherent law of the deformity.OBJECTIVE: To investigate the inherent law between Cobb' s angle of IS and multivariable rotation deformity of top vertebrae.DESIGN: A non-randomized controlled retrospective study was conducted.SETTING and PARTICIPANTS: The study was completed in the Department of Orthopaedics, the Second Affiliated hospital of Harbin Universify. The subjects were patients with IS, 21 males and 16 females, aged 9-32years old.METHODS: Cobb' s angles were measured by anteroposterior X-ray examination of spines. Rotation angles of top vertebral(Aaro method) and angles between axis lines of bilateral top vertebral pedicles and axis lines of top vertebral bodies were measured by CT scan.MAIN OUTCOME MEASURES: Cobb' s angles measured by anteroposterior X-ray examination; rotation angles of top vertebrae and angles between axis lines of bilateral vertebral pedicles and axis lines of vertebral bodies measnred by CT scan.RESULTS: Within 38°-124°, when Cobb' s angles increased 1°, the rotation angles of top vertebrae would increase 0.39°. Angles between axis lines of bilateral top vertebral pedicles and axis lines of top vertebral bodies were (4.72 +6.02)° and (14.22 +6.52)° respectively.CONCLUSION: There are obvious inner link and linear relationship between Cobb' s angles of IS and rotation of top vertebrae. There is significant difference in axis angles between lateral top vertebral pedicles and top vertebral bodies.