Shen Xiao-Long, Tian Ye, Zhou Xu-Hui, Ren Dong, Cao Peng, Yuan Wen
Department of Orthopaedics ChangZheng Hospital Affiliated to Second Military Medical University, Shanghai, China.
Clin Spine Surg. 2017 Jun;30(5):E560-E566. doi: 10.1097/BSD.0000000000000257.
The aim of this study was to analyze the radiologic features of adolescent idiopathic cervical kyphosis.
There are few previous reports about radiographic analysis of cervical sagittal alignment of adolescent idiopathic cervical kyphosis. A new method was proposed in this article to evaluate the severity of cervical kyphosis.
A total of 41 adolescent patients with cervical kyphosis were reviewed. Several angles were measured from the radiographs utilizing the 2-line Cobb method and Harrison posterior tangent method. Ishihara's Curvature Index (CI), Kyphosis Index (KI), kyphosis levels, and the apex of the kyphosis were also measured.
The results showed that the apex of the kyphosis is located at the posterior-superior edge of C4 (70.7%) and C5 (29.3%). C2-C7 angles ranged from 4.7 to 71.3 degrees (36.2±13.6 degrees) and from 9.8 to 83.1 degrees (36.4±15.1 degrees) in the above 2 methods, respectively. Local angles of kyphotic area ranged from 21.8 to 96.3 degrees (50.5±23.7 degrees) in 2-line Cobb method and from 19.8 to 105.6 degrees (52.0±19.5 degrees) in Harrison posterior tangent method. CI and KI ranged from 8.6 to 79.8 (36.8±16.7) and 15.2 to 141.9 (50.6±23.7), respectively. Statistical analysis showed that there was significant positive correlation between KI and kyphosis angle.
In adolescent idiopathic cervical kyphosis, the alteration of the sagittal profile only occurs on partial cervical alignment rather than the whole cervical spine. The apex of the kyphosis locates at posterior-superior edge of the vertebrae. It seems that KI can accurately depict the severity of cervical kyphosis.
本研究旨在分析青少年特发性颈椎后凸畸形的影像学特征。
此前关于青少年特发性颈椎后凸畸形颈椎矢状面排列的影像学分析报道较少。本文提出了一种评估颈椎后凸畸形严重程度的新方法。
共纳入41例青少年颈椎后凸畸形患者。利用二线Cobb法和哈里森后切线法从X线片上测量了几个角度。还测量了石原曲率指数（CI）、后凸指数（KI）、后凸节段及后凸顶点。
结果显示，后凸顶点位于C4后上缘（70.7%）和C5后上缘（29.3%）。上述两种方法中，C2-C7角分别为4.7至71.3度（36.2±13.6度）和9.8至83.1度（36.4±15.1度）。二线Cobb法中后凸区域的局部角度为21.8至96.3度（50.5±23.7度），哈里森后切线法中为19.8至105.6度（52.0±19.5度）。CI和KI分别为8.6至79.8（36.8±16.7）和15.2至141.9（50.6±23.7）。统计分析表明，KI与后凸角度之间存在显著正相关。
在青少年特发性颈椎后凸畸形中，矢状面轮廓改变仅发生在部分颈椎排列而非整个颈椎。后凸顶点位于椎体后上缘。似乎KI可以准确描述颈椎后凸畸形的严重程度。
