青少年特发性脊柱侧凸患者颈椎矢状面形态：一项回顾性病例对照研究
Sagittal morphology of the cervical spine in adolescent idiopathic scoliosis: a retrospective case-control study.
作者信息
Han Shu-Man, Wen Jin-Xu, Cao Lei, Wu Hui-Zhao, Liu Chang, Yang Chen, Yang Hui-Hui, Gao Bu-Lang, Wu Wen-Juan
机构信息
Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
出版信息
Quant Imaging Med Surg. 2022 Jun;12(6):3049-3060. doi: 10.21037/qims-21-902.
BACKGROUND
To investigate the relationship between sagittal alignment and coronal deformity in patients with adolescent idiopathic scoliosis (AIS) through analysis of the spinal imaging data.
METHODS
Four hundred and fifty-four AIS patients who underwent anteroposterior and lateral radiography of the while spine were enrolled, and the spinal parameters of Cobb angle, cervical lordosis, C1-C2 angle, T1 slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt (PT), pelvic incidence (PI), cervical sagittal vertical axis (SVA), and spinal SVA were analyzed.
RESULTS
The patients were divided into two groups according to the size of the Cobb angle: group A (Cobb angle ≤45°, n=414) and group B (Cobb angle >45°, n=40). In group A, the Cobb angle was in a medium negative correlation with the cervical lordosis angle (r=-0.637, P<0.001), a weak positive correlation (|r|<0.3, P<0.05) with C1-C2 angle, T1 slope and thoracic kyphosis. In group B, the Cobb angle was in a mild positive correlation (P<0.05) with PT (r=0.398) and PI (r=0.360). The cervical lordosis angle was significantly (P<0.05) different between male and female patients in both groups. In Group A, the cervical lordosis angle was in a significantly (P<0.01) positive correlation with the T1 slope (r=0.586), thoracic kyphosis (r=0.490), and sagittal vertical axis (r=0.135), and a significantly (P<0.01) negative correlation with cervical sagittal vertical axis (r=-0.128) and C1-C2 angle (r=-0.155). In group B, the cervical lordosis angle was in a significantly (P<0.05) positive correlation with T1 slope (r=0.661), thoracic kyphosis (r=0.608), lumbar lordosis (r=0.425), sacral slope (r=0.434), and sagittal vertical axis (r=0.335).
CONCLUSIONS
In AIS patients with the Cobb angle ≤45º, a significant negative correlation exists between the cervical lordosis and the Cobb angle. The sagittal morphology of the cervical spine in AIS patients is affected by the spinal coronal deformity, which plays an important role in the treatment of AIS.
背景
通过分析脊柱影像数据，探讨青少年特发性脊柱侧凸（AIS）患者矢状面排列与冠状面畸形之间的关系。
方法
纳入454例行全脊柱正侧位X线摄影的AIS患者，分析其Cobb角、颈椎前凸、C1-C2角、T1倾斜角、胸椎后凸、腰椎前凸、骶骨倾斜角、骨盆倾斜（PT）、骨盆入射角（PI）、颈椎矢状垂直轴（SVA）及脊柱SVA等脊柱参数。
结果
根据Cobb角大小将患者分为两组：A组（Cobb角≤45°，n = 414）和B组（Cobb角>45°，n = 40）。在A组中，Cobb角与颈椎前凸角呈中度负相关（r = -0.637，P < 0.001），与C1-C2角、T1倾斜角和胸椎后凸呈弱正相关（|r| < 0.3，P < 0.05）。在B组中，Cobb角与PT（r = 0.398）和PI（r = 0.360）呈轻度正相关（P < 0.05）。两组患者中，颈椎前凸角在男性和女性之间均存在显著差异（P < 0.05）。在A组中，颈椎前凸角与T1倾斜角（r = 0.586）、胸椎后凸（r = 0.490）和矢状垂直轴（r = 0.135）呈显著正相关（P < 0.01），与颈椎矢状垂直轴（r = -0.128）和C1-C2角（r = -0.155）呈显著负相关（P < 0.01）。在B组中，颈椎前凸角与T1倾斜角（r = 0.661）、胸椎后凸（r = 0.608）、腰椎前凸（r = 0.425）、骶骨倾斜角（r = 0.434）和矢状垂直轴（r = 0.335）呈显著正相关（P < 0.05）。
结论
在Cobb角≤45º的AIS患者中，颈椎前凸与Cobb角之间存在显著负相关。AIS患者颈椎的矢状面形态受脊柱冠状面畸形影响，这在AIS的治疗中起重要作用。
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