青少年特发性脊柱侧凸胸弯和胸腰弯/腰弯的结构性侧凸预测因素分析

Background:Recent studies have proven that the Lenke system is relatively efficient and consistent in classifying scoliosis curves. Basically speaking, the fusion should include the main curve and structural minor curve. Minor curve’s structural criteria were established to help guiding the surgeon in this decision-making process. To the best knowledge of the authors, there are no available studies showing the predictors of structural curves. Methods: Age, gender, cobb angle, perdriolle rotation, risser sign, number of vertebrae included in the curve, brace treatment and curve location were recorded from 145 idiopathic scoliosis patients from July 2001 to January 2007. All patients were divided into two groups: structural and non structural group. Demographics and baseline characteristics were compared between the two groups to do an initial screening. Logistic regression was used to analysis for factors affecting minor curves to be structural curves. Results: Structrual group had higher cobb angle(51.34±13.61° vs 34.20±7.21°,P=0.000),bending angle (33.94±9.92° vs. 8..46±5.56°, P=0.000) , curve rotation(23.25±12.86vs14.21±8.55, P=0.000),and lower flexibility(33.48±12.53vs75.50±15.52, P=0.000) than nonstructural curves. Other parameters didn’t show significant difference between the two groups. The results of the Logistic regression analysis show us that for adolescent idiopathic scoliosis, Cobb angle(OR 9.921,P=0.000) and curve location (OR 4.119,P=0.016) were significant predictors of structural curves. That is to say every ten-degree change of Cobb’s angle can increase the possibility of turning the minor curves into structural scoliosis by ten times. And thoracic curves showed, on the average, the possibility of becoming structural curves was about 4 times that of the thoracolumbar/lumbar curves. Conclusions: Curve severity and curve location affects minor curve’s structrual features in adolescent idiopathic scoliosis.