Illés Tamás S, Burkus Máté, Somoskeőy Szabolcs, Lauer Fabien, Lavaste Francois, Dubousset Jean F
Department of Orthopaedics and Traumatology, Brugmann University Hospital, Université Libre de Bruxelles, Place Van Gehuchten 4, 1020, Brussels, Belgium.
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Int Orthop. 2017 Nov;41(11):2303-2311. doi: 10.1007/s00264-017-3548-5. Epub 2017 Aug 11.
A posterior-anterior vertebral vector is proposed to facilitate visualization and understanding of scoliosis. The aim of this study was to highlight the interest of using vertebral vectors, especially in the horizontal plane, in clinical practice.
We used an EOS two-/three-dimensional (2D/3D) system and its sterEOS 3D software for 3D reconstruction of 139 normal and 814 scoliotic spines-of which 95 cases were analyzed pre-operatively and post-operatively, as well. Vertebral vectors were generated for each case. Vertebral vectors have starting points in the middle of the interpedicular segment, while they are parallel to the upper plate, ending in the middle of the segment joining the anterior end plates points, thus defining the posterior-anterior axis of vertebrae. To illustrate what information could be obtained from vertebral vector-based top-view images, representative cases of a normal spine and a thoracic scoliosis are presented.
For a normal spine, vector projections in the transverse plane are aligned with the posterior-anterior anatomical axis. For a scoliotic spine, vector projections in the horizontal plane provide information on the lateral decompensation of the spine and the lateral displacement of vertebrae. In the horizontal plane view, vertebral rotation and projections of the sagittal curves can also be analyzed simultaneously.
The use of posterior-anterior vertebral vector facilitates the understanding of the 3D nature of scoliosis. The approach used is simple. These results are sufficient for a first visual analysis furnishing significant clinical information in all three anatomical planes. This visualization represents a reasonable compromise between mathematical purity and practical use.
提出一种后前椎体向量，以促进对脊柱侧弯的可视化和理解。本研究的目的是强调在临床实践中使用椎体向量的意义，尤其是在水平面中的应用。
我们使用EOS二维/三维（2D/3D）系统及其sterEOS 3D软件对139例正常脊柱和814例脊柱侧弯病例进行三维重建，其中95例在术前和术后均进行了分析。为每个病例生成椎体向量。椎体向量的起点位于椎弓根间段的中点，与上终板平行，终点位于连接前端板点的段的中点，从而确定椎体的后前轴。为了说明从基于椎体向量的顶视图图像中可以获得哪些信息，展示了正常脊柱和胸段脊柱侧弯的代表性病例。
对于正常脊柱，矢状面的向量投影与后前解剖轴对齐。对于脊柱侧弯的脊柱，水平面的向量投影提供了有关脊柱侧方失代偿和椎体侧方移位的信息。在水平面视图中，还可以同时分析椎体旋转和矢状曲线的投影。
使用后前椎体向量有助于理解脊柱侧弯的三维性质。所采用的方法简单。这些结果足以进行初步视觉分析，在所有三个解剖平面上提供重要的临床信息。这种可视化在数学纯度和实际应用之间达成了合理的平衡。
