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未治疗的中重度 AIS 患者骨盆形态、躯干姿势和站立平衡不良与 Cobb 角的关系

Pelvis morphology, trunk posture and standing imbalance and their relations to the Cobb angle in moderate and severe untreated AIS.

机构信息

Faculté des Sciences de l'Homme et de l'Environnement, CURAPS-DIMPS, Université de la Réunion, Le Tampon, France.

出版信息

PLoS One. 2012;7(7):e36755. doi: 10.1371/journal.pone.0036755. Epub 2012 Jul 5.

Abstract

Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and usually affects young girls. Studies mostly describe the differences between scoliotic and non-scoliotic girls and focus primarily on a single set of parameters derived from spinal and pelvis morphology, posture or standing imbalance. No study addressed all these three biomechanical aspects simultaneously in pre-braced AIS girls of different scoliosis severity but with similar curve type and their interaction with scoliosis progression. The first objective of this study was to test if there are differences in these parameters between pre-braced AIS girls with a right thoracic scoliosis of moderate (less than 27°) and severe (more than 27°) deformity. The second objective was to identify which of these parameters are related to the Cobb angle progression either individually or in combination of thereof. Forty-five scoliotic girls, randomly selected by an orthopedic surgeon from the hospital scoliosis clinic, participated in this study. Parameters related to pelvis morphology, pelvis orientation, trunk posture and quiet standing balance were measured. Generally moderate pre-brace idiopathic scoliosis patients displayed lower values than the severe group characterized by a Cobb angle greater than 27°. Only pelvis morphology and trunk posture were statistically different between the groups while pelvis orientation and standing imbalance were similar in both groups. Statistically significant Pearson coefficients of correlation between individual parameters and Cobb angle ranged between 0.32 and 0.53. Collectively trunk posture, pelvis morphology and standing balance parameters are correlated with Cobb angle at 0.82. The results suggest that spinal deformity progression is not only a question of trunk morphology distortion by itself but is also related to pelvis asymmetrical bone growth and standing neuromuscular imbalance.

摘要

青少年特发性脊柱侧凸(AIS)是最常见的脊柱侧凸类型,通常影响年轻女孩。研究大多描述了脊柱侧凸和非脊柱侧凸女孩之间的差异,并主要集中在一组源自脊柱和骨盆形态、姿势或站立平衡的参数上。没有研究同时在不同严重程度但具有相似曲线类型的未支具 AIS 女孩中,解决所有这三个生物力学方面的问题,以及它们与脊柱侧凸进展的相互作用。本研究的第一个目的是测试中度(小于 27°)和重度(大于 27°)脊柱畸形的未支具 AIS 女孩之间这些参数是否存在差异。第二个目的是确定这些参数中哪些与 Cobb 角进展有关,无论是单独的还是组合的。45 名脊柱侧凸女孩由骨科医生从医院脊柱侧凸诊所随机选择,参加了这项研究。测量了与骨盆形态、骨盆方位、躯干姿势和安静站立平衡有关的参数。一般来说,中度支具前特发性脊柱侧凸患者的数值低于严重组,其 Cobb 角大于 27°。只有骨盆形态和躯干姿势在两组之间存在统计学差异,而骨盆方位和站立平衡在两组中相似。个体参数与 Cobb 角之间的统计学显著 Pearson 相关系数介于 0.32 和 0.53 之间。总体而言,躯干姿势、骨盆形态和站立平衡参数与 Cobb 角的相关性为 0.82。结果表明,脊柱畸形进展不仅是躯干形态扭曲的问题,还与骨盆不对称骨生长和站立神经肌肉失衡有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d761/3390341/6b770bf79430/pone.0036755.g001.jpg

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