Vavruch Ludvig, Forsberg Daniel, Dahlström Nils, Tropp Hans
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Sectra, Linköping, Sweden.
Spine Deform. 2018 Mar-Apr;6(2):112-120.e1. doi: 10.1016/j.jspd.2017.09.001.
Retrospective study.
To investigate parameters of axial vertebral deformation in patients with scoliosis compared to a control group, and to determine whether these parameters correlated with the severity of spine curvature, measured as the Cobb angle.
Adolescent idiopathic scoliosis (AIS) is the most common type of spinal deformity. Many studies have investigated vertebral deformation, in terms of wedging and pedicle deformations, but few studies have investigated actual structural changes within vertebrae.
This study included 20 patients with AIS (Lenke 1-3, mean age: 15.6 years, range: 11-20). We compared preoperative low-dose computed tomography (CT) examinations of patients with AIS to those of a control group matched for age and sex. The control individuals had no spinal deformity, but they were admitted to the emergency department for trauma CTs. We measured the Cobb angles and the axial vertebral rotation (AVR), axial vertebral body asymmetry (AVBA), and frontal vertebral body rotation (FVBR) for the superior end, inferior end, and apical vertebrae, with in-house-developed software. Correlations between entities were investigated with the Pearson correlation test.
The average Cobb angles were 49.3° and 1.3° for the scoliotic and control groups, respectively. The patient and control groups showed significant differences in the AVRs of all three vertebra levels (p < .01), the AVBAs of the superior end and apical vertebrae (p < .008), and the FVBR of the apical vertebra (p = .011). Correlations were only found between the AVBA and FVBR in the superior end vertebra (r = 0.728, p < .001) and in the apical vertebra (r = 0.713, p < .001).
Compared with controls, patients with scoliosis showed clear morphologic differences in the midaxial plane vertebrae. Differences in AVR, AVBA, and FVBR were most pronounced at the apical vertebra. The FVBR provided valuable additional information about the internal rotation and deformation of vertebrae.
Level III.
回顾性研究。
与对照组相比，研究脊柱侧弯患者的轴向椎体变形参数，并确定这些参数是否与以Cobb角衡量的脊柱侧弯严重程度相关。
青少年特发性脊柱侧弯（AIS）是最常见的脊柱畸形类型。许多研究已经从椎体楔形变和椎弓根变形方面对椎体变形进行了研究，但很少有研究调查椎体内的实际结构变化。
本研究纳入了20例AIS患者（Lenke 1-3型，平均年龄：15.6岁，范围：11-20岁）。我们将AIS患者术前的低剂量计算机断层扫描（CT）检查结果与年龄和性别匹配的对照组进行了比较。对照组个体无脊柱畸形，但因创伤CT检查而入住急诊科。我们使用自行开发的软件测量了上位椎体、下位椎体和顶椎的Cobb角、轴向椎体旋转（AVR）、轴向椎体不对称（AVBA）和额状位椎体旋转（FVBR）。采用Pearson相关检验研究各指标之间的相关性。
脊柱侧弯组和对照组的平均Cobb角分别为49.3°和1.3°。患者组和对照组在所有三个椎体水平的AVR（p < 0.01）、上位椎体和顶椎的AVBA（p < 0.008）以及顶椎的FVBR（p = 0.011）方面存在显著差异。仅在上位椎体（r = 0.728，p < 0.001）和顶椎（r = 0.713，p < 0.001）中发现AVBA和FVBR之间存在相关性。
与对照组相比，脊柱侧弯患者在中轴平面椎体上表现出明显的形态学差异。AVR、AVBA和FVBR的差异在顶椎最为明显。FVBR为椎体的内部旋转和变形提供了有价值的额外信息。
三级。
