Schmitz Alfred, König Roy, Kandyba Jörg, Pennekamp Peter, Schmitt Ottmar, Jaeger Ursula E
Department of Orthopaedics, University of Bonn, Sigmund-Freud Strasse 25, 53105, Bonn, Germany.
Eur Spine J. 2005 Mar;14(2):138-43. doi: 10.1007/s00586-004-0788-z. Epub 2004 Oct 5.
We studied the brace effect on the spinal profile in idiopathic scoliosis, using a MR procedure visualising the complete scoliotic spine in any vertical plane, while rotating it 180 degrees on the longitudinal axis of the patient. Thirty-eight female patients (mean age, 14.5 years) were included in the study. Inclusion criteria were an idiopathic scoliosis, a Cobb angle greater than 20 degrees , age of 10-17 years and bracing with a Cheneau brace. The brace effect was studied in 38 thoracic curves. The MR examinations were carried out in direct sequences, with and without brace. A reconstruction algorithm allows visualising the whole spine in vertical projections, with rotational steps of 2 degrees , from -90 degrees to 90 degrees , referred to as MR animation. In various vertical MR projections, the changes of the curves were evaluated by measuring the Cobb angle. Additionally, a translation angle of the apical vertebra was determined, representing the lateral deviation of the apical vertebra from a defined midline. Testing the reproducibility of the Cobb angles, the standard deviation of the intra-individual differences was 1.7 degrees and of the inter-individual differences, 2.1 degrees . For the translation angles, the standard deviation of the intra-individual differences was 0.8 degrees and of the inter-individual differences, 0.9 degrees . With brace the mean Cobb angle of the thoracic curves was significantly reduced in the various vertical MR projections. The mean translation angle was also reduced. MR analysis showed that the brace effect is a translation process, straightening the profile of the scoliotic spine in all vertical planes. MR animation allows visualising the brace effect on the spine in scoliosis based on a 3D data set, without additional radiation exposure. It showed the straightening effect of the brace leading to a flattening of the sagittal spinal profile.
我们采用一种磁共振成像（MR）程序研究了支具对特发性脊柱侧凸患者脊柱外形的影响，该程序可在任何垂直平面上可视化整个脊柱侧凸，并使脊柱在患者纵轴上旋转180度。38名女性患者（平均年龄14.5岁）纳入本研究。纳入标准为特发性脊柱侧凸、Cobb角大于20度、年龄10 - 17岁且使用Cheneau支具进行支具治疗。对38个胸段弯曲进行了支具效果研究。MR检查在直接序列下进行，分别在佩戴和不佩戴支具的情况下。一种重建算法可在垂直投影中以2度的旋转步长、从 - 90度到90度可视化整个脊柱，这被称为MR动画。在各种垂直MR投影中，通过测量Cobb角评估弯曲的变化。此外，还确定了顶椎的平移角，代表顶椎相对于定义中线的侧向偏移。测试Cobb角的可重复性，个体内差异的标准差为1.7度，个体间差异的标准差为2.1度。对于平移角，个体内差异的标准差为0.8度，个体间差异的标准差为0.9度。佩戴支具后，在各种垂直MR投影中胸段弯曲的平均Cobb角显著减小。平均平移角也减小。MR分析表明，支具效果是一个平移过程，可在所有垂直平面上使脊柱侧凸的外形变直。MR动画能够基于三维数据集可视化支具对脊柱侧凸患者脊柱的影响，且无需额外的辐射暴露。它显示了支具的矫直效果，导致脊柱矢状面外形变平。
