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中国人青少年特发性脊柱侧弯中椎弓根的患病率及分布:基于2958个椎弓根的计算机断层扫描研究

The Prevalence and Distribution of Vertebral Pedicles in Adolescent Idiopathic Scoliosis in Chinese people: A Computed Tomography-Based Study of 2958 Vertebral Pedicles.

作者信息

Huang Jie, Zhang Peng, Jian Xiaofei, Jiang Honghui

机构信息

Department of Orthopedics, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Second Department of Surgery, Jinyintan Hospital of Wuhan, Wuhan, China.

出版信息

World Neurosurg. 2018 Nov;119:e560-e567. doi: 10.1016/j.wneu.2018.07.211. Epub 2018 Aug 2.

DOI:10.1016/j.wneu.2018.07.211
PMID:30077019
Abstract

OBJECTIVE

To explore the prevalence and distribution of abnormal vertebral pedicles in adolescent idiopathic scoliosis (AIS) in Chinese people.

METHODS

We retrospectively reviewed AIS patients at a single institution between 2011 and 2017. Transverse pedicle widths from T1 to L5 were measured carefully using computed tomography, including cancellous and cortical channels. Pedicle morphology was classified as: type A, a cancellous channel larger than 4 mm; type B, a cancellous channel measuring 2-4 mm; type C, a cancellous channel smaller than 2 mm with an entirely cortical channel of 2 mm or greater; or type D, a cortical channel smaller than 2 mm. Types B, C, and D were defined as abnormal. Prevalence and distribution of abnormal pedicles were assessed.

RESULTS

Eighty-seven patients with AIS, with a total of 2958 vertebral pedicles, were carefully measured and classified. The total prevalence of abnormal vertebral pedicles was as high as 65%, with type B comprising 40%, type C comprising 23%, and type D comprising 2%. Pedicles were located between T2 and T10 in 84% of type C and 91% of type D cases. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles.

CONCLUSIONS

There is a significantly high prevalence of abnormal pedicles in AIS in Chinese people, with a total prevalence of 65%. Female sex, proximal thoracic location, major curve greater than 70 degrees, and concave pedicle may be risk factors for type C and D pedicles.

摘要

目的

探讨青少年特发性脊柱侧凸(AIS)患者中中国人异常椎弓根的患病率及分布情况。

方法

我们回顾性分析了2011年至2017年在单一机构就诊的AIS患者。使用计算机断层扫描仔细测量了T1至L5的横径椎弓根宽度,包括松质骨通道和皮质骨通道。椎弓根形态分为:A型,松质骨通道大于4mm;B型,松质骨通道为2 - 4mm;C型,松质骨通道小于2mm且皮质骨通道完全为2mm或更大;或D型,皮质骨通道小于2mm。B、C和D型被定义为异常。评估了异常椎弓根的患病率及分布情况。

结果

对87例AIS患者共2958个椎弓根进行了仔细测量和分类。异常椎弓根的总患病率高达65%,其中B型占40%,C型占23%,D型占2%。84%的C型和91%的D型病例中椎弓根位于T2至T10之间。女性、胸段近端位置、主弯大于70度以及凹侧椎弓根可能是C型和D型椎弓根的危险因素。

结论

中国人AIS患者中异常椎弓根的患病率显著较高,总患病率为65%。女性、胸段近端位置、主弯大于70度以及凹侧椎弓根可能是C型和D型椎弓根的危险因素。

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