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后路弯棒矫形技术下胸椎特发性脊柱侧凸冠状面节段柔韧性的研究

Coronal plane segmental flexibility in thoracic adolescent idiopathic scoliosis assessed by fulcrum-bending radiographs.

机构信息

Orthopaedic Departments, University Children's Hospital, Roemergasse 8, 4005, Basel, Switzerland.

出版信息

Eur Spine J. 2010 May;19(5):732-8. doi: 10.1007/s00586-010-1320-2. Epub 2010 Feb 26.


DOI:10.1007/s00586-010-1320-2
PMID:20186443
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2899966/
Abstract

Knowledge about segmental flexibility in adolescent idiopathic scoliosis is crucial for a better biomechanical understanding, particularly for the development of fusionless, growth-guiding techniques. Currently, there is lack of data in this field. The objective of this study was, therefore, to compute segmental flexibility indices (standing angle minus corrected angle/standing angle). We compared segmental disc angles in 76 preoperative sets of standing and fulcrum-bending radiographs of thoracic curves (paired, two-tailed t tests, p < 0.05). The mean standing Cobb angle was 59.7 degrees (range 41.3 degrees -95 degrees ) and the flexibility index of the curve was 48.6% (range 16.6-78.8%). The disc angles showed symmetric periapical distribution with significant decrease (all p values <0.0001) for every cephalad (+) and caudad (-) level change. The periapical levels +1 and -1 wedged at 8.3 degrees and 8.7 degrees (range 3.5 degrees -14.8 degrees ), respectively. All angles were significantly smaller on the-bending views (p values <0.0001). We noted mean periapical flexibility indices of 46% (+1), 49% (-1), 57% (+2) and 81% (-2), which were significantly less (p < 0.001) than for the group of remote levels 105% (+3), 149% (-3), 231% (+4) and 300% (-4). The discal and bony wedging was 60 and 40%, respectively, and mean values 35 degrees and 24 degrees (p < 0.0001). Their relationship with the Cobb angle showed a moderate correlation (r = 0.56 and 0.45). Functional, radiographic analysis of idiopathic thoracic scoliosis revealed significant, homogenous segmental tethering confined to four periapical levels. Future research will aim at in vivo segmental measurements in three planes under defined load to provide in-depth data for novel therapeutic strategies.

摘要

青少年特发性脊柱侧凸的节段柔韧性知识对于更好地理解生物力学至关重要,特别是对于开发无融合、生长引导技术而言。目前,该领域缺乏数据。因此,本研究的目的是计算节段柔韧性指数(站立角度减去校正角度/站立角度)。我们比较了 76 例术前站立位和支点弯曲位胸弯的影像学资料(配对双侧 t 检验,p<0.05)。平均站立 Cobb 角为 59.7 度(范围 41.3 度-95 度),曲线的柔韧性指数为 48.6%(范围 16.6-78.8%)。椎间盘角度呈对称的根尖分布,每向上(+)和向下(-)一个椎体水平变化均显著减小(所有 p 值均<0.0001)。根尖水平+1 和-1 分别楔变 8.3 度和 8.7 度(范围 3.5 度-14.8 度)。所有角度在弯曲位均显著减小(p 值均<0.0001)。我们记录了平均根尖柔韧性指数为 46%(+1)、49%(-1)、57%(+2)和 81%(-2),明显小于(p<0.001)远节段 105%(+3)、149%(-3)、231%(+4)和 300%(-4)的柔韧性指数。椎间盘和骨的楔变分别为 60%和 40%,平均为 35 度和 24 度(p<0.0001)。它们与 Cobb 角的关系呈中度相关(r=0.56 和 0.45)。特发性胸弯的功能、影像学分析显示,显著的、同质的节段性固定局限于四个根尖水平。未来的研究将旨在在三个平面下进行有定义负荷的节段体内测量,为新的治疗策略提供深入的数据。

相似文献

[1]
Coronal plane segmental flexibility in thoracic adolescent idiopathic scoliosis assessed by fulcrum-bending radiographs.

Eur Spine J. 2010-2-26

[2]
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[3]
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[6]
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[7]
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引用本文的文献

[1]
Segmental range-of-motion by vertebral level in fused and unfused patients with adolescent idiopathic scoliosis: a systematic review of the literature.

Spine Deform. 2025-1

[2]
Morphological alterations of lumbar intervertebral discs in patients with adolescent idiopathic scoliosis.

Spine J. 2024-1

[3]
Effects of spinal deformities on lung development in children: a review.

J Orthop Surg Res. 2023-3-27

[4]
Adolescent Idiopathic Scoliosis Treated by Posterior Spinal Segmental Instrumented Fusion : When Is Fusion to L3 Stable?

J Korean Neurosurg Soc. 2021-9

[5]
Prediction of Scoliosis Curve Correction Using Pedicle Screw Constructs in AIS: A Comparison of Fulcrum Bend Radiographs and Traction Radiographs Under General Anesthesia.

Global Spine J. 2018-10

[6]
A retrospective controlled clinical study of Cobb angle distribution of the main thoracic curve in adolescent idiopathic scoliosis.

Medicine (Baltimore). 2018-7

[7]
Characteristics of Cobb angle distribution in the main thoracolumbar/lumbar curve in adolescent idiopathic scoliosis: A retrospective controlled clinical study.

Medicine (Baltimore). 2018-6

[8]
Sexual Dimorphism and the Origins of Human Spinal Health.

Endocr Rev. 2018-4-1

[9]
The radiographic parameter risk factors of rapid curve progression in Lenke 5 and 6 adolescent idiopathic scoliosis: A retrospective study.

Medicine (Baltimore). 2017-12

[10]
The effect of scoliotic deformity on spine kinematics in adolescents.

Scoliosis Spinal Disord. 2016-10-25

本文引用的文献

[1]
Assessment of spinal flexibility in adolescent idiopathic scoliosis: suspension versus side-bending radiography.

Spine (Phila Pa 1976). 2009-3-15

[2]
The effect of soft tissue properties on spinal flexibility in scoliosis: biomechanical simulation of fulcrum bending.

Spine (Phila Pa 1976). 2009-1-15

[3]
The effect of intra-operative skeletal (skull femoral) traction on apical vertebral rotation.

Eur Spine J. 2009-3

[4]
The value of radiographs obtained during forced traction under general anaesthesia in predicting flexibility in idiopathic scoliosis with Cobb angles exceeding 60 degree.

J Bone Joint Surg Br. 2008-11

[5]
The role of the intervertebral disc in correction of scoliotic curves. A theoretical model of idiopathic scoliosis pathogenesis.

Stud Health Technol Inform. 2008

[6]
Preoperative planning simulator for spinal deformity surgeries.

Spine (Phila Pa 1976). 2008-9-15

[7]
A novel fusionless vertebral physeal device inducing spinal growth modulation for the correction of spinal deformities.

Eur Spine J. 2008-10

[8]
Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis - A cross sectional study in 150 patients.

Scoliosis. 2008-8-13

[9]
The use of fulcrum bending radiographs in anterior thoracic scoliosis correction: a consecutive series of 90 patients.

Spine (Phila Pa 1976). 2008-4-20

[10]
Traction versus supine side-bending radiographs in determining flexibility: what factors influence these techniques?

Spine (Phila Pa 1976). 2007-11-1

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