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在患有 Potts 畸形的患者中,不同的角状后凸位置与主动脉和脊柱的相对位置不同。

Different angular kyphosis locations have different relative positions of aorta to spine in patients with Pott's deformity.

机构信息

Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China.

Department of Orthopedics, Changzheng Hospital, Second Military University, No.415 Fengyang Road, Shanghai, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2022 Apr 20;23(1):372. doi: 10.1186/s12891-022-05331-8.

Abstract

BACKGROUND

The position of the aorta relative to the spine in kyphosis secondary to Pott's deformity is little understood. The purpose of this study was to investigate the anatomic relationship between the aorta and the spine in patients with Pott's deformity and to compare it with the normal people.

METHODS

Seventy-six patients with Pott's deformity (Group TB) and seventy-two age- and sex-matched patients with a normal spine (group NC) were enrolled in this study. The relative position of aorta to the spine was evaluated from T4 to L4 on the computed tomographic angiography scans for controls and at the apex level for TB patient, and was classified into 4 kinds of degrees.

RESULTS

The left pedicle-aorta angle in group TB was significantly larger than that in group NC at the T6-L3 levels. Group TB exhibited significantly smaller left pedicle-aorta distance, pedicular line-aorta distance and vertebra/rib-aorta distance than those in group NC at the T5-T10 levels, but bigger at the L1-3 levels. Patients with grade 3 and 4 aorta had more segments involved compared with those with grade 1 aorta. Patients with grade 2, 3, and 4 aorta showed larger kyphotic angles than those with grade 1.

CONCLUSIONS

Patients whose morbid segments involved only thoracic vertebrae presented with an "Ω" shaped aorta in sagittal plane, and 4 different kinds of degrees of aorta relative to the vertebra/rib in axial plane. Patients whose morbid segments covered lumbar vertebrae presented with an "M" shaped aorta in sagittal plane, and the aorta shifted further from apex vertebra but was located in close proximity to the vertebral body at levels above and below the osteotomy levels in axial plane.

摘要

背景

在脊柱后凸畸形继发于Potts 病时,主动脉相对于脊柱的位置尚不清楚。本研究的目的是探讨 Potts 病患者主动脉与脊柱的解剖关系,并与正常人进行比较。

方法

本研究纳入了 76 例 Potts 病患者(TB 组)和 72 例年龄和性别匹配的脊柱正常患者(NC 组)。在 CT 血管造影扫描中评估对照组 T4 至 L4 节段和 TB 患者脊柱后凸顶点水平主动脉与脊柱的相对位置,并将其分为 4 种程度。

结果

TB 组的左侧椎弓根-主动脉角在 T6-L3 水平明显大于 NC 组。TB 组在 T5-T10 水平的左侧椎弓根-主动脉距离、椎弓根线-主动脉距离和椎体/肋骨-主动脉距离明显小于 NC 组,但在 L1-3 水平则明显较大。3 级和 4 级主动脉患者受累节段比 1 级主动脉患者更多。2 级、3 级和 4 级主动脉患者的后凸角大于 1 级主动脉患者。

结论

仅累及胸椎的病变节段患者在矢状面呈“Ω”形主动脉,在轴面有 4 种不同程度的主动脉相对于椎体/肋骨。累及腰椎的病变节段患者在矢状面呈“M”形主动脉,主动脉从顶点椎体进一步移位,但在轴面截骨水平上下的椎体附近位置更接近。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e51/9022242/b3245dd05ce3/12891_2022_5331_Fig1_HTML.jpg

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