Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104-4399, USA.
Eur Spine J. 2018 Sep;27(9):2223-2232. doi: 10.1007/s00586-018-5553-9. Epub 2018 Mar 21.
To determine the link between the rate of spontaneous lumbar curve correction (SLCC) and the sagittal profile characteristics both before and after selective thoracic fusion in Lenke 1 adolescent idiopathic scoliosis (AIS).
Sixty-three Lenke 1 B and C were enrolled and followed up to 2 years. Twenty non-scoliotic controls were included. 3D reconstruction of the spine was generated from bi-planar X-rays at pre-operative, first erect post-operative, and the most recent follow-up. The 3D spinal models were used to determine the frontal and sagittal Cobb angles and 3D coordinate of each vertebral centroid. A K-mean cluster analysis allocated patients into two groups based on the rate of SLCC between the pre-operative and the most recent follow-up visits (SLCC and SLCC groups). The ratio of the thoracic to lumbar curve apical translations in sagittal plane was determined. ANOVA test compared the sagittal apical translation ratio between the three visits of the AIS clusters and between the AIS groups and controls.
The rate of the SLCC was significantly different between the two clusters: 31% (SLCC) versus 76% (SLCC). No significant difference was found between the two clusters pre-operative Cobb angles, kyphosis, and lordosis. The pre-operative ratio of the thoracic to lumbar apical translation in the sagittal plane was significantly lower in SLCC compared to SLCC group, a magnitude of 1.2 and 2.2, respectively, p < 0.05.
In Lenke 1, patients with a higher pre-operative sagittal thoracic to lumbar apical translation ratio are associated with lower rate of SLCC at the most recent follow-up. These slides can be retrieved under Electronic Supplementary Material.
确定自发性腰椎曲线矫正（SLCC）率与 Lenke 1 青少年特发性脊柱侧凸（AIS）选择性胸椎融合前后矢状轮廓特征之间的关系。
纳入 63 例 Lenke 1B 和 C 型患者，并随访 2 年。纳入 20 例非脊柱侧凸对照者。术前、初次直立术后和最近随访时，采用双平面 X 线对脊柱进行 3D 重建。使用 3D 脊柱模型确定额状面和矢状面 Cobb 角以及每个椎体质心的 3D 坐标。根据术前和最近随访时 SLCC 的变化率（SLCC 和 SLCC 组），采用 K-均值聚类分析将患者分为两组。在 AIS 聚类的三个访视点之间以及在 AIS 组和对照组之间，比较矢状面顶椎平移比。方差分析（ANOVA）检验比较了 AIS 聚类的三个访视点之间以及 AIS 组和对照组之间的矢状面顶椎平移比。
两组间 SLCC 的发生率差异有统计学意义：31%（SLCC）与 76%（SLCC）。两组间术前 Cobb 角、后凸和前凸无显著差异。与 SLCC 组相比，SLCC 组术前矢状面胸椎到腰椎顶椎平移比显著降低，分别为 1.2 和 2.2，p < 0.05。
在 Lenke 1 型中，术前矢状面胸椎到腰椎顶椎平移比较大的患者，最近随访时 SLCC 的发生率较低。这些幻灯片可以在电子补充材料中检索到。
