Alexandre Anderson Sales, Sperandio Evandro Fornias, Yi Liu Chiao, Davidson Josy, Poletto Patrícia Rios, Gotfryd Alberto Ofenhejm, Vidotto Milena Carlos
Universidade Federal de São Paulo, Santos, SP, Brasil.
Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Rev Paul Pediatr. 2019 Apr-Jun;37(2):225-233. doi: 10.1590/1984-0462/;2019;37;2;00001. Epub 2019 Jul 22.
To evaluate the chest wall shape in patients with adolescent idiopathic scoliosis (AIS) in comparison to healthy subjects and the association between the chest wall shape with the spine deformity and lung function in patients with AIS.
This cross-sectional study enrolled 30 AIS patients and 20 healthy subjects aged 11-18 years old. The Cobb angle evaluation was performed in AIS patients. The chest wall shape was assessed by the photogrammetry method, using the Postural Assessment Software (PAS). We created thoracic markers shaped as angles (A) and distances (D), as follows: A2 (right acromion/xiphoid/left acromion), A4L (angle formed between the outer point of the smallest waist circumference and its upper and lower edges on the left side), A7 (angle formed by the intersection of the tangent segments of the upper and lower scapulae angles), D1R/D1L [distance between the xiphoid process and the last false rib on the right (R) and left (L) sides], and D3 (distance between xiphoid process and anterior superior iliac spine).
The thoracic markers A2 and A7 were significantly higher, while the A4L and D1R/D1L were significantly reduced in the AIS group compared to the control. Moderate correlations were found between: A2 and the main and proximal thoracic Cobb angles (r=0.50, r=0.47, respectively); D1R/D1L and the main thoracic Cobb angle (r=- 0.40); and the forced expiratory volume in the first second (FEV1) and D3R (r=0.47).
The photogrammetry method was able to detect chest wall changes in AIS patients, besides presenting correlation between Cobb angles and lung function.
与健康受试者相比，评估青少年特发性脊柱侧凸（AIS）患者的胸壁形态，以及AIS患者胸壁形态与脊柱畸形和肺功能之间的关联。
这项横断面研究纳入了30例年龄在11 - 18岁的AIS患者和20例健康受试者。对AIS患者进行Cobb角评估。采用摄影测量法，使用姿势评估软件（PAS）评估胸壁形态。我们创建了呈角度（A）和距离（D）形状的胸廓标记，如下：A2（右肩峰/剑突/左肩峰）、A4L（左侧最小腰围外点与其上下边缘形成的角度）、A7（上下肩胛骨角切线段交点形成的角度）、D1R/D1L [剑突与右侧（R）和左侧（L）最后一根假肋之间的距离]，以及D3（剑突与髂前上棘之间的距离）。
与对照组相比，AIS组的胸廓标记A2和A7显著更高，而A4L和D1R/D1L显著降低。在以下各项之间发现了中度相关性：A2与胸段主 Cobb角和近端 Cobb角（分别为r = 0.50，r = 0.47）；D1R/D1L与胸段主 Cobb角（r = - 0.40）；以及第1秒用力呼气量（FEV1）和D3R（r = 0.47）。
摄影测量法除了能呈现Cobb角与肺功能之间的相关性外，还能够检测AIS患者的胸壁变化。
