Leroux M A, Zabjek K, Simard G, Badeaux J, Coillard C, Rivard C H
Department of Surgery, Université de Montréal and Sainte-Justine Hospital, Montréal, Canada.
Spine (Phila Pa 1976). 2000 Jul 1;25(13):1689-94. doi: 10.1097/00007632-200007010-00012.
Cross-sectional measurement of the sagittal geometry of adolescent idiopathic scoliosis patients.
To evaluate the accuracy of a noninvasive anthropometric approach for the measurement of kyphosis and lordosis.
Noninvasive approaches were developed to estimate the sagittal curvatures of the spine. However, the magnitude of the estimation error could be high for an important proportion of patients, which leads to a difficult clinical application.
The group was composed of 124 female patients with a mean age of 13.5 years (SD 2. 7 years) with Cobb angles ranging from 4 degrees to 66 degrees. Kyphosis and lordosis were measured on the lateral radiograph. The spine sagittal curvature of the same patients was also estimated using the spatial localization of skin markers placed overlying the spinous processes. These coordinates served as input into a simple trigonometric model. Data were collected by means of a stereovideographic technique (Motion Analysis Corp., Santa Rosa, CA).
The intraclass correlation coefficient between both approaches was 0.94 for kyphosis and 0.91 for lordosis; the mean absolute differences were 5 degrees (SD 4 degrees ) and 6 degrees (SD 6 degrees ), respectively. The difference was less than 10 degrees in 91% of the patients for kyphosis, and in 79% for lordosis.
The proposed technique appears to give more representative results than those presented in the literature. It has the advantage of being part of a global noninvasive postural evaluation. Using this approach in a systematic manner could help reduce radiograph exposure while keeping track of the spine sagittal curvatures.
青少年特发性脊柱侧凸患者矢状面几何形态的横断面测量。
评估一种用于测量脊柱后凸和前凸的无创人体测量方法的准确性。
已开发出无创方法来估计脊柱的矢状面曲度。然而,对于相当一部分患者,估计误差可能很大,这导致临床应用困难。
该组由124名女性患者组成,平均年龄13.5岁(标准差2.7岁),Cobb角范围为4度至66度。在侧位X线片上测量脊柱后凸和前凸。还通过放置在棘突上的皮肤标记的空间定位来估计同一患者的脊柱矢状面曲度。这些坐标作为输入到一个简单的三角模型中。数据通过立体摄像技术(Motion Analysis Corp.,加利福尼亚州圣罗莎)收集。
两种方法之间的组内相关系数,脊柱后凸为0.94,脊柱前凸为0.91;平均绝对差值分别为5度(标准差4度)和6度(标准差6度)。91%的患者脊柱后凸差异小于10度,79%的患者脊柱前凸差异小于10度。
所提出的技术似乎比文献中报道的结果更具代表性。它具有作为整体无创姿势评估一部分的优势。系统地使用这种方法有助于减少X线片曝光,同时跟踪脊柱矢状面曲度。