Biomechanics & Spine Research Group, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia.
Queensland Children's Hospital and Mater Health Services, Brisbane, Australia.
Spine (Phila Pa 1976). 2023 Dec 1;48(23):1642-1651. doi: 10.1097/BRS.0000000000004829. Epub 2023 Sep 13.
A prospective cohort study.
Detail typical three-dimensional segmental deformities and their rates of change that occur within developing adolescent idiopathic scoliosis (AIS) spines over multiple timepoints.
AIS is a potentially progressive deforming condition that occurs in three dimensions of the scoliotic spine during periods of growth. However, there remains a gap for multiple timepoint segmental deformity analysis in AIS cohorts during development.
Thirty-six female patients with Lenke 1 AIS curves underwent two to six sequential magnetic resonance images. Scans were reformatted to produce images in orthogonal dimensions. Wedging angles and rotatory values were measured for segmental elements within the major curve. Two-tailed, paired t tests compared morphologic differences between sequential scans. Rates of change were calculated for variables given the actual time between successive scans. Pearson correlation coefficients were determined for multidimensional deformity measurements.
Vertebral bodies were typically coronally convexly wedged, locally lordotic, convexly axially rotated, and demonstrated evidence of local mechanical torsion. Between the first and final scans, apical measures of coronal wedging and axial rotation were all greater in both vertebral and intervertebral disk morphology than nonapical regions (all reaching differences where P <0.05). No measures of sagittal deformity demonstrated a statistically significant change between scans. Cross-planar correlations were predominantly apparent between coronal and axial planes, with sagittal plane parameters rarely correlating across dimensions. Rates of segmental deformity changes between earlier scans were characterized by coronal plane convex wedging and convexly directed axial rotation. The major locally lordotic deformity changes that did occur in the sagittal plane were static between scans.
This novel investigation documented a three-dimensional characterization of segmental elements of the growing AIS spine and reported these changes across multiple timepoints. Segmental elements are typically deformed from initial presentation, and subsequent changes occur in separate orthogonal planes at unique times.
前瞻性队列研究。
详细描述在多个时间点发生在发育中青少年特发性脊柱侧凸（AIS）脊柱中的典型三维节段性畸形及其变化率。
AIS 是一种潜在的进行性变形疾病，在生长期间会在脊柱侧弯的三个维度上发生。然而，在 AIS 队列的发育过程中，仍存在多个时间点节段性畸形分析的空白。
36 名女性 Lenke 1 AIS 曲线患者接受了 2 到 6 次连续的磁共振成像。扫描结果被重新格式化，以生成正交维度的图像。主要曲线上的节段性元素的楔形角度和旋转值进行了测量。双侧配对 t 检验比较了连续扫描之间的形态差异。考虑到连续扫描之间的实际时间，计算了变量的变化率。确定了多维变形测量的 Pearson 相关系数。
椎体通常呈冠状凸楔形，局部前凸，凸轴向旋转，并显示出局部机械扭转的证据。在第一次和最后一次扫描之间，椎体和椎间盘形态的冠状楔形和轴向旋转的顶点测量值均大于非顶点区域（所有差异均达到 P<0.05）。矢状面畸形的任何测量值在扫描之间均未显示出统计学上的显著变化。横断面上的平面相关性主要表现在冠状面和轴向平面之间，矢状面参数很少在不同维度上相关。早期扫描之间节段性变形变化的速率特征是冠状面凸楔形和凸向轴向旋转。矢状面确实发生的主要局部前凸畸形变化在扫描之间是静态的。
这项新的研究对生长中的 AIS 脊柱的节段性元素进行了三维特征描述，并在多个时间点报告了这些变化。节段性元素通常从初始表现开始变形，随后在不同的正交平面上以独特的时间发生变化。
