Chan Chris Yin Wei, Chiu Chee Kidd, Kwan Mun Keong
Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Spine (Phila Pa 1976). 2016 Aug 15;41(16):E973-E980. doi: 10.1097/BRS.0000000000001516.
A prospective study.
The aim of this study was to analyze the proximal thoracic (PT) flexibility and its compensatory ability above the "potential UIV."
Shoulder and neck imbalance can be caused by overcorrection of the main thoracic (MT) curve due to inability of PT segment to compensate.
Cervical supine side bending (CSB) radiographs of 100 Lenke 1 and 2 patients were studied. We further stratified Lenke 1 curves into Lenke 1-ve: PT side bending (PTSB) < 15° (n = 33) and Lenke 1+ve: PTSB 15° to 24.9° (n = 37). The right side bending (RSB) and left side bending (LSB) angles were measured (T1-T6). Compensatory ability of the PT segment was analyzed with assumption of a "horizontal UIV" position.
From T1 to T6 vertebrae, the RSB angle values showed increasing positive values. The LSB angle, comparing Lenke 1-ve versus 2 and Lenke 1+ve versus 2, showed significant difference at T2 to T6. The LSB angle comparing Lenke 1-ve versus 1+ve achieved significant difference at T5 and T6. In Lenke 2 curves, >80.0% of cases of the PT segment were unable to compensate at T3-T6. In Lenke 1+ve curves, 78.4% were unable to compensate at T6, followed by T5 (75.7%), T4 (73.0%), T3 (59.5%), T2 (27.0%), and T1 (21.6%). In Lenke 1-ve curves, 36.4% of cases were unable to compensate at T6, followed by T5 (45.5%), T4 (45.5%), T3 (30.3%), T2 (21.2%), and T1 (15.2%). A significant difference between Lenke 1-ve and Lenke 1+ve was observed from T3 to T6. The difference between Lenke 1+ve and Lenke 2 curves was significant only at T2.
The compensation ability and the flexibility of the PT segments of Lenke 1-ve and Lenke 1+ve curves were different. Lenke 1+ve curves demonstrated similar characteristics to Lenke 2 curves.
前瞻性研究。
本研究旨在分析胸段近端（PT）的柔韧性及其在“潜在上位胸弯（UIV）”上方的代偿能力。
由于PT节段无法代偿，主胸弯（MT）过度矫正可导致肩颈失衡。
对100例Lenke 1型和2型患者的颈椎仰卧位侧弯（CSB）X线片进行研究。我们进一步将Lenke 1型曲线分为Lenke 1阴性：PT侧弯（PTSB）<15°（n = 33）和Lenke 1阳性：PTSB 15°至24.9°（n = 37）。测量右侧弯（RSB）和左侧弯（LSB）角度（T1-T6）。假设“水平UIV”位置，分析PT节段的代偿能力。
从T1至T6椎体，RSB角度值呈递增的正值。比较Lenke 1阴性与2型以及Lenke 1阳性与2型，LSB角度在T2至T6有显著差异。比较Lenke 1阴性与1阳性，LSB角度在T5和T6有显著差异。在Lenke 2型曲线中，>80.0%的PT节段病例在T3-T6无法代偿。在Lenke 1阳性曲线中，78.4%在T6无法代偿，其次是T5（75.7%）、T4（73.0%）、T3（59.5%）、T2（27.0%）和T1（21.6%）。在Lenke 1阴性曲线中，36.4%的病例在T6无法代偿，其次是T5（45.5%）、T4（45.5%）、T3（30.3%）、T2（21.2%）和T1（15.2%）。从T3至T6观察到Lenke 1阴性和Lenke 1阳性之间有显著差异。Lenke 1阳性和Lenke 2型曲线之间的差异仅在T2有显著性。
Lenke 1阴性和Lenke 1阳性曲线的PT节段的代偿能力和柔韧性不同。Lenke 1阳性曲线表现出与Lenke 2型曲线相似的特征。
3级。
