Fitzgerald Ryan, Upasani Vidyadhar V, Bastrom Tracey P, Bartley Carrie E, Reighard Fredrick G, Yaszay Burt, Newton Peter O
Department of Orthopedics, Riley Children's Hospital, Indianapolis, IN.
Department of Orthopedics, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92023, USA; Department of Orthopedics, Rady Children's Hospital, San Diego, CA.
Spine Deform. 2019 Jan;7(1):66-70. doi: 10.1016/j.jspd.2018.06.005.
Retrospective review of three-dimensional (3D) imaging from a multicenter database of surgically treated adolescent idiopathic scoliosis (AIS) patients.
To use 3D analysis software to compare Lenke 1AR and 1AL curves in the coronal, sagittal, and axial planes.
The Lenke 1AR and AL curve patterns have been shown to be two distinct curve types, with 1AL curves being more likely to add on after fusion. Analysis in 3D may help define some of the intricacies of these two curves.
Ninety-four AIS patients with Lenke 1A curves and upright biplanar scanned radiographs were reviewed. Analysis was performed using 3D reconstruction software to evaluate the 3D coronal, sagittal and axial plane deformities. Coronal L4 tilt was used to distinguish between the two curve patterns.
The main thoracic Cobb was not significantly different between the AR (n = 43) and AL (n = 51) curves (52° ± 8° vs. 50° ± 5°; p = .25). The thoracolumbar/lumbar Cobb was significantly smaller in the AR curves (28° ± 8° vs. 32° ± 7°; p = .02). In the sagittal plane, T5-T12 kyphosis and T12-S1 lordosis were not significantly different (p >.2); however, the T10-L2 alignment was significantly more lordotic in the AR curves (11° ± 8° vs. 4° ± 10° lordosis; p <.001). In the axial plane, thoracic apical rotation was significantly greater in AR curves (21° ± 6° vs. 14° ± 6°; p <.001) and lumbar apical rotation was significantly smaller in AR curves (1° ± 5° vs. 6° ± 5°; p <.001).
3D spinal analysis demonstrates that 1AR and AL curves are distinctly different in all three planes. Although the treatment-based Lenke classification system combines these two curve patterns into one curve type, the 3D assessment suggests there are clear features that differentiate these curve patterns. The differing features of the nonstructural lumbar curves may help define the variance in fusion level selection and risk of adding-on for these two curve patterns.
Level II, prognostic.
对手术治疗的青少年特发性脊柱侧凸（AIS）患者多中心数据库中的三维（3D）成像进行回顾性分析。
使用3D分析软件比较Lenke 1AR和1AL曲线在冠状面、矢状面和轴位面上的情况。
Lenke 1AR和AL曲线模式已被证明是两种不同的曲线类型，1AL曲线在融合后更有可能出现附加弯。三维分析可能有助于明确这两种曲线的一些复杂情况。
回顾了94例患有Lenke 1A曲线且有站立位双平面扫描X线片的AIS患者。使用3D重建软件进行分析，以评估三维冠状面、矢状面和轴位面畸形。采用L4椎体冠状面倾斜度来区分这两种曲线模式。
AR组（n = 43）和AL组（n = 51）的主胸弯Cobb角无显著差异（52°±8° vs. 50°±5°；p = 0.25）。AR组的胸腰段/腰段Cobb角显著更小（28°±8° vs. 32°±7°；p = 0.02）。在矢状面，T5 - T12后凸角和T12 - S1前凸角无显著差异（p > 0.2）；然而，AR组的T10 - L2矢状面排列的前凸更显著（前凸角1l°±8° vs. 4°±10°；p < 0.001）。在轴位面上，AR组的胸椎顶椎旋转度显著更大（21°±6° vs. 14°±6°；p < 0.001），而AR组的腰椎顶椎旋转度显著更小（1°±5° vs. 6°±5°；p < 0.001）。
三维脊柱分析表明，1AR和AL曲线在所有三个平面上均有明显差异。尽管基于治疗的Lenke分类系统将这两种曲线模式归为一种曲线类型，但三维评估表明存在明确特征可区分这些曲线模式。非结构性腰弯的不同特征可能有助于明确这两种曲线模式在融合节段选择和附加弯发生风险方面的差异。
II级，预后性。
