Nielsen Ena, Goldstein Rachel Y
Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS#69, Los Angeles, CA 90027, USA.
J Hip Preserv Surg. 2018 Mar 9;5(2):131-136. doi: 10.1093/jhps/hny004. eCollection 2018 Jul.
Changes in spino-pelvic alignment can lead to changes in acetabular coverage and predispose those with spinal pathologies to hip pathologies. The purpose of this study was to define the incidence of acetabular overcoverage in pediatric spine patients. Retrospective review of charts and EOS radiographs was conducted for patients ≤21 years old with adolescent idiopathic scoliosis (AIS) or Scheuermann's Kyphosis (SK) who were treated with posterior spinal fusion (PSF) between 12/01/2015-7/26/2016. Radiographs were measured for lateral center edge angles (LCEA), anterior center edge angle (ACEA), and lumbar lordosis pre- and postoperatively. 32 patients met inclusion criteria. Preoperatively, mean LCEA was 44.1 degrees (range: 32-55, SD: 5.1) on the right and 42.8 degrees (range: 33-52, SD: 4.4) on the left. Mean preoperative ACEA was 56.0 degrees (range: 35-90, SD: 10.4). Mean preoperative lordosis was 56.0 degrees (range: -22-105, SD: 19.1) Preoperative LCEA was not associated with lordosis (right: = 0.002, = 0.78, left: = 0.006, = 0.66). Preoperative ACEA was no associated with lordosis ( = 0.02, = 0.49). Overall, the mean percent change in LCEA was -3.4% (range: -19.6-21.9, SD: 10.3) on the right and -3.5% (range: -31.0-27.9, SD: 13.3) on the left. Mean percent change in ACEA was 9.1% (range: -20.6-35.7, SD: 15.1). Mean percent change in lordosis was -12.2% (range: -150-33.3, SD: 33.3. The incidence of acetabular overcoverage may be significantly higher in a pediatric spinal population than the general population. Careful monitoring of these patients for signs and symptoms of hip pathology may be warranted.
脊柱-骨盆对线的改变可导致髋臼覆盖度的变化，并使患有脊柱疾病的患者易患髋关节疾病。本研究的目的是确定小儿脊柱疾病患者髋臼过度覆盖的发生率。对2015年12月1日至2016年7月26日期间接受后路脊柱融合术（PSF）治疗的≤21岁青少年特发性脊柱侧凸（AIS）或休门氏后凸（SK）患者的病历和EOS X线片进行回顾性分析。测量术前和术后的X线片上的外侧中心边缘角（LCEA）、前侧中心边缘角（ACEA）和腰椎前凸。32例患者符合纳入标准。术前，右侧平均LCEA为44.1度（范围：32-55度，标准差：5.1），左侧为42.8度（范围：33-52度，标准差：4.4）。术前平均ACEA为56.0度（范围：35-90度，标准差：10.4）。术前平均前凸为56.0度（范围：-22-105度，标准差：19.1）。术前LCEA与前凸无关（右侧：r = 0.002，p = 0.78，左侧：r = 0.006，p = 0.66）。术前ACEA与前凸无关（r = 0.02，p = 0.49）。总体而言，右侧LCEA的平均变化百分比为-3.4%（范围：-19.6-21.9，标准差：10.3），左侧为-3.5%（范围：-31.0-27.9，标准差：13.3）。ACEA的平均变化百分比为9.1%（范围：-20.6-35.7，标准差：15.1）。前凸的平均变化百分比为-12.2%（范围：-150-33.3，标准差：33.3）。小儿脊柱疾病患者髋臼过度覆盖的发生率可能显著高于普通人群。可能有必要对这些患者进行仔细监测，以观察髋关节疾病的体征和症状。
