Division of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Bone Miner Res. 2017 Nov;32(11):2257-2262. doi: 10.1002/jbmr.3210. Epub 2017 Aug 2.
A small vertebral cross-sectional area (CSA) imparts a mechanical disadvantage that escalates the risk for vertebral fractures in elderly populations. We examined whether a small vertebral CSA is also associated with a greater degree of vertebral wedging in children. Measurements of vertebral CSA, lumbar lordosis (LL) or thoracic scoliosis angle, and vertebral wedging were obtained in 100 healthy adolescents (50 boys and 50 girls) and 25 girls with adolescent idiopathic scoliosis (AIS) using magnetic resonance imaging. Vertebral CSA of the lumbar vertebrae negatively correlated to the degree of posteroanterior vertebral wedging at L (r = -0.49; p < 0.0001); this was true whether all subjects were analyzed together or boys and girls independently. In contrast, we found a positive correlation between the degree of LL and vertebral wedging (r = 0.57; p < 0.0001). Multiple regression analysis showed that the association between vertebral CSA and wedging was independent of age and body mass index. In girls with AIS, vertebral CSA negatively correlated to the degree of lateral thoracic vertebral wedging (r = -0.66; p = 0.0004), an association that persisted even after accounting for age and body mass index. Additionally, Cobb angle positively correlated to lateral thoracic vertebral wedging (r = 0.46; p = 0.021). Our cross-sectional results support the hypothesis that smaller vertebral CSA is associated with greater vertebral deformity during growth, as in adulthood. © 2017 American Society for Bone and Mineral Research.
一个较小的椎体横截面积（CSA）会带来机械劣势，从而增加老年人群椎体骨折的风险。我们研究了较小的椎体 CSA 是否也与儿童更大程度的椎体楔形变相关。使用磁共振成像，我们对 100 名健康青少年（50 名男孩和 50 名女孩）和 25 名患有青少年特发性脊柱侧凸（AIS）的女孩的椎体 CSA、腰椎前凸（LL）或胸椎侧凸角度以及椎体楔形变进行了测量。腰椎 CSA 与 L 椎体的前后向椎体楔形变程度呈负相关（r = -0.49；p < 0.0001）；无论整体分析还是男孩和女孩分别分析，结果均如此。相比之下，我们发现 LL 程度与椎体楔形变呈正相关（r = 0.57；p < 0.0001）。多元回归分析表明，椎体 CSA 与楔形变之间的关联独立于年龄和体重指数。在患有 AIS 的女孩中，椎体 CSA 与侧胸椎体楔形变程度呈负相关（r = -0.66；p = 0.0004），即使在考虑了年龄和体重指数后，这种关联仍然存在。此外，Cobb 角与侧胸椎体楔形变呈正相关（r = 0.46；p = 0.021）。我们的横断面研究结果支持了这样的假设，即在生长过程中，较小的椎体 CSA 与更大的椎体变形相关，就像在成年期一样。 © 2017 美国骨矿研究协会。
