Stokes I A, Moreland M S
Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington.
Spine (Phila Pa 1976). 1989 Jan;14(1):73-8. doi: 10.1097/00007632-198901000-00015.
In order to determine why topographic methods have shown a poor correlation with radiographically measured scoliosis in clinical studies, the accuracy of detection of the presence, side, apex, and magnitude of a scoliosis curve was determined topographically (by moiré fringe photography and by projected raster photography) in 104 patients attending a scoliosis clinic. The presence or absence of thoracic curves was correctly shown by the topograms in 77% of cases, and in the lower region (lumbar and thoracolumbar curves) in 79% of cases. For correctly identified curves, the greatest back surface rotation was, on average, 1.0 vertebral levels below the skeletal curve apex in the thoracic region and 0.5 levels below the apex in the lower region. The moiré fringe with the greatest asymmetry occurred on average at 1.5 and 1.8 vertebral levels above the spinal apex in upper and lower regions, respectively. The magnitude of the Cobb angle was determined to within +/- 5 degrees in 24% of cases by moiré measurements, and in 27% by the raster technique. The side of the scoliosis was incorrectly diagnosed by topography in ten patients with minimal or 'nonstandard' vertebral rotation. It was concluded that the presence, level, and side of a scoliosis curvature is well demonstrated by back surface topography in patients with 'standard' rotation, but the magnitude of the scoliosis cannot be determined from topograms sufficiently accurately for most clinical purposes.
为了确定在临床研究中地形学方法与X线测量的脊柱侧弯相关性较差的原因，对104名脊柱侧弯门诊患者进行了地形学检查（通过莫尔条纹摄影和投影光栅摄影），以确定脊柱侧弯曲线的存在、侧弯方向、顶点及严重程度的检测准确性。在77%的病例中，胸段曲线的存在与否通过体表图正确显示，在79%的病例中，下胸段（腰段和胸腰段曲线）情况亦是如此。对于正确识别的曲线，胸段区域平均最大后表面旋转位于骨骼曲线顶点下方1.0个椎体水平，下胸段区域位于顶点下方0.5个椎体水平。莫尔条纹最大不对称性平均分别出现在上、下区域脊柱顶点上方1.5和1.8个椎体水平处。通过莫尔测量，24%的病例中Cobb角大小的测定误差在±5度以内，通过光栅技术测定的比例为27%。在10例椎体旋转最小或“非标准”的患者中，地形学检查错误地诊断了脊柱侧弯的方向。得出的结论是，对于“标准”旋转的患者，体表地形学能很好地显示脊柱侧弯的存在、水平和方向，但对于大多数临床目的而言，无法从体表图足够准确地确定脊柱侧弯的严重程度。
