Ugur Fatih, Topal Kubra, Albayrak Mehmet, Topal Murat
Orthopedics and Traumatology, Faculty of Medicine, Kastamonu University, Kastamonu, TUR.
Otolaryngology - Head and Neck Surgery, Private Practice, Kastamonu, TUR.
Cureus. 2023 Oct 19;15(10):e47307. doi: 10.7759/cureus.47307. eCollection 2023 Oct.
Introduction Scoliosis, a multifaceted spinal deformity commonly affecting pediatric and adolescent populations, has spurred extensive scientific inquiry to understand its origins and impacts. Early-onset scoliosis (EOS), characterized by spinal curvature exceeding 10° before the age of 10, presents a unique challenge necessitating a comprehensive understanding of its etiological factors. Within this context, the potential role of hypoxia-induced by adenoid hypertrophy in contributing to the pathogenesis of EOS has emerged as an intriguing avenue of investigation. Materials and methods This retrospective study was conducted focusing on radiological and clinical data pertaining to children below 10 years of age who underwent isolated adenoidectomy for adenoid hypertrophy. Preoperative posteroanterior standing chest radiographs were utilized for scoliosis assessment, with Cobb angles serving as the primary measurement metric. To ensure accuracy and reliability, Cobb angle measurements were independently performed by two experienced observers. Statistical analyses encompassed the Mann-Whitney U test, Spearman correlation analysis, and intraclass correlation coefficient calculations to evaluate interobserver agreement. Results Among the cohort of 218 pediatric adenoidectomy patients, 177 individuals had radiographs suitable for EOS evaluation. The mean age of the participants was 5.72±2 years, with a nearly equal distribution of 52.5% male and 47.5% female patients. Strikingly, the study identified a 10.2% prevalence of coronal plane curvatures exceeding the critical threshold of 10°, indicative of EOS. The robust interobserver reliability was demonstrated by a commendable mean interclass correlation coefficient (ICC) value of 0.926, affirming consistent and accurate Cobb angle measurements between the observers. Conclusion In light of the heightened prevalence of EOS observed in children undergoing adenoidectomy, this study provides a compelling impetus for exploring the potential interrelationship between adenoid hypertrophy, hypoxia, and the emergence of early-onset scoliosis. The study underscores the importance of prospective research to elucidate the complex mechanisms connecting these factors, offering insights into potential risk factors and underlying pathogenic pathways associated with the development of early-onset scoliosis.
引言
脊柱侧弯是一种多方面的脊柱畸形，常见于儿童和青少年群体，引发了广泛的科学探究以了解其起源和影响。早发性脊柱侧弯（EOS）的特征是在10岁之前脊柱弯曲超过10°，这带来了独特的挑战，需要全面了解其病因。在此背景下，腺样体肥大引起的缺氧在EOS发病机制中的潜在作用已成为一个有趣的研究途径。
材料与方法
本回顾性研究聚焦于10岁以下因腺样体肥大接受单纯腺样体切除术的儿童的放射学和临床数据。术前站立位后前位胸部X线片用于脊柱侧弯评估，Cobb角作为主要测量指标。为确保准确性和可靠性，由两名经验丰富的观察者独立进行Cobb角测量。统计分析包括Mann-Whitney U检验、Spearman相关性分析和组内相关系数计算，以评估观察者间的一致性。
结果
在218例接受腺样体切除术的儿科患者队列中，177例个体的X线片适合进行EOS评估。参与者的平均年龄为5.72±2岁，男性患者占52.5%，女性患者占47.5%，分布近乎相等。令人惊讶的是，该研究发现冠状面弯曲超过关键阈值10°的患病率为10.2%，表明存在EOS。观察者间的可靠信度通过值得称赞的平均组内相关系数（ICC）值0.926得以证明，确认了观察者之间Cobb角测量的一致性和准确性。
结论
鉴于在接受腺样体切除术的儿童中观察到EOS患病率升高，本研究为探索腺样体肥大、缺氧与早发性脊柱侧弯出现之间的潜在相互关系提供了有力推动。该研究强调了前瞻性研究的重要性，以阐明连接这些因素的复杂机制，为与早发性脊柱侧弯发展相关的潜在风险因素和潜在致病途径提供见解。
