Department of Pediatric Orthopedics and Scoliosis Surgery, Hôpitaux pédiatriques de Nice CHU LENVAL, 57 Avenue de la Californie, Nice, France.
Eur Spine J. 2020 Sep;29(9):2281-2286. doi: 10.1007/s00586-020-06373-z. Epub 2020 Mar 18.
Distal thoracic kyphosis (DTK) equivalent to proximal lumbar lordosis (PLL) is the sum of pelvic tilt (PT) and the difference (Δ) between lumbar lordosis (LL) and pelvic incidence (PI): PLL = DTK = PT + Δ. With the assumption that proximal thoracic kyphosis (PTK) is similar to DTK, we propose the equation TK = 2(PT + LL - PI) to express the relationship between thoracic kyphosis (TK) and pelvic parameters. The objective of this work is to verify this relationship in a normal population.
Full spine radiographs of 100 adolescents and young adults (13 to 20 years old), free from vertebral pathology, were analyzed. Measurements included pelvic parameters, LL, PLL, DLL, TK, PTK, DTK and C7 global tilt. The measured global TK was compared with the theoretical TK calculated according to the formula TK = 2(PT + LL - PI).
The difference between measured TK and calculated TK was + 2.3° and correlated with the C7 global tilt (r = 0.86). There was a significant linear regression between TK and PT + ∆ (p < 0.0001). Given radiographs' inter-rater reliability of 5° for angled measurements, the p value (0.047) between measured TK and calculated TK is statistically significant to support the hypothesis.
This work validates the formula TK = 2(PT + LL - PI) which allows the calculation of global TK as a function of PT, LL and PI. This calculated TK can be used as a target for sagittal correction of adolescents with spine deformities. These slides can be retrieved under Electronic Supplementary Material.
胸腰段后凸（DTK）等同于腰椎前凸（PLL），是骨盆倾斜（PT）与腰椎前凸（LL）和骨盆入射角（PI）差值（Δ）的总和：PLL=DTK=PT+Δ。假设胸上段后凸（PTK）与 DTK 相似，我们提出方程 TK=2（PT+LL-PI）来表达胸椎后凸（TK）与骨盆参数之间的关系。本研究的目的是验证该关系在正常人群中的适用性。
分析了 100 名青少年和年轻人（13 至 20 岁）的全脊柱 X 光片，这些人没有椎体病变。测量内容包括骨盆参数、LL、PLL、DLL、TK、PTK、DTK 和 C7 整体倾斜度。测量的整体 TK 与根据公式 TK=2（PT+LL-PI）计算的理论 TK 进行比较。
测量的 TK 与计算的 TK 之间的差异为+2.3°，与 C7 整体倾斜度相关（r=0.86）。TK 与 PT+Δ之间存在显著的线性回归关系（p<0.0001）。考虑到倾斜测量的放射学组内可信度为 5°，测量的 TK 与计算的 TK 之间的 p 值（0.047）具有统计学意义，支持这一假设。
本研究验证了公式 TK=2（PT+LL-PI），该公式允许将全球 TK 作为 PT、LL 和 PI 的函数进行计算。该计算的 TK 可用于脊柱畸形青少年的矢状面矫正。这些幻灯片可在电子补充材料中检索。
