Jarvis J G, Ashman R B, Johnston C E, Herring J A
University of Ottawa, Children's Hospital of Eastern Ontario, Canada.
Clin Orthop Relat Res. 1988 Feb;227:126-34.
The hypothesis that a localized lordosis, or tethering of the posterior elements of the spine, is the primary cause of the vertebral rotation in idiopathic scoliosis was investigated in anatomic specimens of human and calf spinal columns. The specimens were axially loaded with and without a posterior tether created using Zielke instrumentation. Lateral deflection and axial rotation were monitored roentgenographically. The vertebrae of tethered spines showed increased rotation in the direction associated with idiopathic scoliosis. The spinous processes moved toward the concavity at the apex of the induced lateral curve. Conversely, untethered spines either exhibited little rotation or rotated in the opposite direction; the spinous processes moved toward the convexity of the curve. Rotations toward the convexity occur in rotational kyphosis. Thus the hypothesis that idiopathic scoliosis is a rotational lordosis is substantiated; the characteristic rotation can be explained with the aid of a geometric model.
在人和小牛脊柱的解剖标本中，研究了局部脊柱前凸或脊柱后部结构束缚是特发性脊柱侧凸椎体旋转主要原因这一假说。使用 Zielke 器械对标本施加轴向负荷，有或没有形成后部束缚。通过 X 线摄影监测侧方偏斜和轴向旋转。有束缚的脊柱椎体在与特发性脊柱侧凸相关的方向上旋转增加。棘突向诱导侧凸顶点的凹侧移动。相反，无束缚的脊柱要么几乎不旋转，要么向相反方向旋转；棘突向曲线的凸侧移动。向凸侧的旋转发生在旋转性后凸中。因此，特发性脊柱侧凸是旋转性脊柱前凸这一假说得到了证实；借助几何模型可以解释其特征性旋转。
