Suk Kyung-Soo, Kim Ki-Tack, Lee Sang-Hun, Kim Jin-Moon
Department of Orthopaedic Surgery, School of Medicine, Kyung-Hee University, Seoul, Korea.
Spine (Phila Pa 1976). 2003 Sep 1;28(17):2001-5. doi: 10.1097/01.BRS.0000083239.06023.78.
A prospective study.
To assess the significance of chin-brow vertical angle in planning and evaluating the correction of kyphotic deformity with ankylosis of the cervical spine in ankylosing spondylitis patients.
Accurate assessment and measurement of spinal kyphotic deformity is required when planning treatment and assessing its results.
Thirty-four ankylosing spondylitis patients with cervical ankylosis who had undergone pedicle subtraction extension osteotomy for correction of kyphotic deformity were studied. Radiographic assessment for sagittal balance was performed by measuring thoracic kyphosis, lumbar lordosis, the distance between the vertical line on the anterosuperior point of T1 and that of S1, and sacral inclination. Chin-brow vertical angle was measured on the clinical photos of the patients. Clinical outcomes were assessed by a questionnaire.
The preoperative and postoperative chin-brow vertical angles were 35.5 degrees and 1.8 degrees, respectively. Final follow-up radiographs showed an increase in lumbar lordosis from 5.5 degrees to 43.2 degrees (an increase of 37.7 degrees ), and thoracic kyphosis remained stable from 50.4 degrees to 50.2 degrees. Sagittal imbalance significantly improved from 101.5 mm to 12.7 mm. The decreased chin-brow vertical angle correlated negatively with the correction angle. The patients with a chin-brow vertical angle of less than -10 degrees had significantly low scores on horizontal gaze.
Chin-brow vertical angle was an objective index for evaluating horizontal gaze. Based on the results of this study, measurement of chin-brow vertical angle is recommended for planning correction of kyphosis and accurate evaluation of treatment outcome.
前瞻性研究。
评估强直性脊柱炎患者颈椎融合后驼背畸形矫正计划制定及评估中眉-颏垂直角的意义。
制定脊柱驼背畸形治疗计划并评估其效果时，需要准确评估和测量脊柱驼背畸形。
对34例因颈椎融合而接受椎弓根截骨延长术以矫正驼背畸形的强直性脊柱炎患者进行研究。通过测量胸椎后凸、腰椎前凸、T1前上点垂直线与S1垂直线之间的距离以及骶骨倾斜度，对矢状面平衡进行影像学评估。在患者的临床照片上测量眉-颏垂直角。通过问卷调查评估临床疗效。
术前和术后眉-颏垂直角分别为35.5度和1.8度。末次随访X线片显示腰椎前凸从5.5度增加到43.2度（增加37.7度），胸椎后凸从50.4度稳定至50.2度。矢状面失衡从101.5毫米显著改善至12.7毫米。眉-颏垂直角减小与矫正角度呈负相关。眉-颏垂直角小于-10度的患者水平凝视评分显著较低。
眉-颏垂直角是评估水平凝视的客观指标。基于本研究结果，建议在制定驼背矫正计划及准确评估治疗效果时测量眉-颏垂直角。
