Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing, P.R. China.
Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing, P.R. China.
World Neurosurg. 2019 Jul;127:e1-e7. doi: 10.1016/j.wneu.2019.01.036. Epub 2019 Mar 7.
To investigate the position of the aorta relative to the spine in patients with de novo lumbar scoliosis (DLS).
This study enrolled 142 patients with DLS, including 80 cases of left thoracolumbar/lumbar scoliosis (left group) and 62 cases of right scoliosis (right group). In addition, 132 cases free of deformity were allocated to the control group. Parameters of the Cobb angle and apical vertebrae were measured by radiograph, whereas the left pedicle-vertebrae angle (α), rotation angle (γ), and left pedicle-vertebrae distance (d) of T12-L4 were obtained by magnetic resonance imaging. Independent sample t test was performed to compare α, γ, and d between the DLS and control groups, followed by a Pearson correlation analysis to study the correlation between Cobb angle and α, γ, and d.
No difference was found between the right group and control group (P = 0.554). The value of mean d (4.62 ± 0.57 cm) gradually increased from T12 to L4 in the left group and showed significant difference with the corresponding value in the control group (4.44 ± 0.43 cm; P < 0.001). There was no significant difference between the right group and control group (P = 0.762). The value of mean d (4.54 ± 1.84 cm) showed no significant difference between the right group and control group (P = 0.530). The correlation analysis showed a significant correlation between rotation angle γ and Cobb angle (P < 0.001), but not in α and d with Cobb angle.
Although the position of the aorta relative to the spine showed no significant difference between patients with DLS and normal subjects, great attention should still be paid to prevent DLS-induced aorta injury.
探讨新诊断腰椎侧凸(DLS)患者主动脉与脊柱的相对位置。
本研究纳入 142 例 DLS 患者,其中 80 例为胸腰椎/腰椎左侧凸(左侧组),62 例为右侧凸(右侧组)。另外,132 例无畸形患者被分配到对照组。通过 X 线片测量 Cobb 角和顶椎参数,通过磁共振成像(MRI)获得 T12-L4 的左侧椎弓根椎体角(α)、旋转角(γ)和左侧椎弓根椎体距离(d)。采用独立样本 t 检验比较 DLS 组与对照组之间的α、γ和 d,然后进行 Pearson 相关性分析,研究 Cobb 角与α、γ和 d 的相关性。
右侧组与对照组之间无差异(P=0.554)。左侧组的平均 d 值(4.62±0.57cm)从 T12 逐渐增加到 L4,与对照组的相应值有显著差异(P<0.001)。右侧组与对照组之间无显著差异(P=0.762)。右侧组的平均 d 值(4.54±1.84cm)与对照组无显著差异(P=0.530)。相关性分析显示,旋转角γ与 Cobb 角呈显著相关(P<0.001),但α和 d 与 Cobb 角无显著相关。
尽管 DLS 患者主动脉与脊柱的相对位置与正常人群无显著差异,但仍应高度重视,以防止 DLS 引起的主动脉损伤。