脊柱侧凸的前方延长仅发生在椎间盘，且在不同类型的脊柱侧凸中相似。
Anterior lengthening in scoliosis occurs only in the disc and is similar in different types of scoliosis.
机构信息
Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
出版信息
Stud Health Technol Inform. 2021 Jun 28;280:58-62. doi: 10.3233/SHTI210435.
Relative anterior spinal overgrowth (RASO) was proposed as a generalized growth disturbance and a potential initiator of adolescent idiopathic scoliosis (AIS). However, anterior lengthening was also observed in neuromuscular (NM) scoliosis, was shown to be restricted to the apical areas and to be located in the intervertebral discs, not in the bone. In this study the goal was to determine if other scoliotic curves of known origin exhibit the similar mechanism of anterior lengthening without changes in the vertebral body. Therefore CT-scans of 18 patients in whom a short segment congenital malformation had led to a long thoracic compensatory curve without bony abnormality were included. Of each vertebral body and intervertebral disc in the compensatory curve, the anterior and posterior length was measured on CT-scans in the exact mid-sagittal plane, corrected for deformity in all three planes. The total AP% of the compensatory curve in congenital scoliosis showed a lordosis (+1.8%) that differed from the kyphosis in non-scoliotic controls (-3.0%; p<0.001), and was comparable to AIS (+1.2%) and NM scoliosis (+0.5%). This anterior lengthening was not located in the bone; the vertebral body AP% showed a kyphosis (-3.2%), similar to non-scoliotic controls (-3.4%), as well as AIS (-2.5%) and NM scoliosis (-4.5%; p=1.000). However, the disc AP% showed a lordosis (+24.3%), which sharply contrasts to the kyphotic discs of controls (-1.5%; p<0.001), but was similar to AIS (+17.5%) and NM scoliosis (+20.5%). The results demonstrate that anterior lengthening is part of the three-dimensional deformity in different types of scoliosis and is exclusively located in the intervertebral discs. The bony vertebral bodies maintain their kyphotic shape, which indicates that there is no active bony overgrowth. Anterior lengthening appears to be a passive result of any scoliotic deformity, rather than being related to the specific cause of AIS.
相对前方脊柱过度生长（RASO）被认为是一种全身性生长障碍，也是青少年特发性脊柱侧凸（AIS）的潜在诱因。然而，神经肌肉（NM）脊柱侧凸也观察到了前方延长，这种延长被限制在顶点区域，并位于椎间盘内，而不是骨内。在这项研究中，我们的目的是确定其他已知起源的脊柱侧凸曲线是否表现出类似的前方延长机制，而不改变椎体。因此，我们纳入了 18 名患者的 CT 扫描，这些患者的先天性短节段畸形导致长胸补偿性曲线，但无骨异常。在补偿性曲线上，每个椎体和椎间盘，在精确的正中矢状面上，在所有三个平面上进行畸形校正后，测量其前后长度。先天性脊柱侧凸的补偿性曲线的总 AP%表现出前凸（+1.8%），与非脊柱侧凸对照组的后凸（-3.0%）不同（p<0.001），与 AIS（+1.2%）和 NM 脊柱侧凸（+0.5%）相似。这种前方延长不是发生在骨内；椎体的 AP%表现为后凸（-3.2%），与非脊柱侧凸对照组（-3.4%）相似，与 AIS（-2.5%）和 NM 脊柱侧凸（-4.5%）相似（p=1.000）。然而，椎间盘的 AP%表现出前凸（+24.3%），与对照组的后凸椎间盘（-1.5%）形成鲜明对比（p<0.001），但与 AIS（+17.5%）和 NM 脊柱侧凸（+20.5%）相似。结果表明，前方延长是不同类型脊柱侧凸三维畸形的一部分，仅发生在椎间盘内。骨性椎体保持其后凸形状，这表明没有骨质过度生长。前方延长似乎是任何脊柱侧凸畸形的被动结果，而与 AIS 的具体病因无关。
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