Zhao Chong, Zhu Shuaiqi, Liang Yan, Xu Shuai
Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing, People's Republic of China.
Int J Gen Med. 2024 Sep 7;17:3945-3953. doi: 10.2147/IJGM.S478933. eCollection 2024.
To characterize the asymmetrical loss of bone mass and identify the association between scoliosis and osteopenia in patients with adolescent idiopathic scoliosis (AIS).
Demographic information, Cobb angle, and Hounsfield unit (HU) of the neutral vertebra (NV) and apical vertebra (apex) of the major curve were collected retrospectively in 54 AIS patients. For 84 control subjects, HU values were measured at T12 and L5. Propensity score matching was performed to balance the interference of age and BMI.
In the AIS group, the concave and convex lateral HU of the NV and the convex lateral HU of the apex were negatively correlated with the Cobb angle. The AIS patients had lower bilateral HU. The mean HU and the apex-convex HU were also lower in the AIS group, while the apex-concave HU was slightly higher. After matching, the apex-convex HU of the AIS group remained lower, while the apex-concave HU was higher.
Patients with AIS exhibit osteopenia, particularly on the convex side. The severity of scoliosis was found to be directly proportional to the severity of bone loss and the degree of bilateral osteopenia asymmetry. Appropriate intervention for bone loss may be able to curb the progression of scoliosis.
描述青少年特发性脊柱侧凸（AIS）患者骨量的不对称性丢失，并确定脊柱侧凸与骨质减少之间的关联。
回顾性收集54例AIS患者的人口统计学信息、Cobb角以及主弯中立椎（NV）和顶椎的Hounsfield单位（HU）。对84名对照受试者，在T12和L5测量HU值。进行倾向得分匹配以平衡年龄和BMI的干扰。
在AIS组中，NV的凹侧和凸侧横向HU以及顶椎的凸侧横向HU与Cobb角呈负相关。AIS患者双侧HU较低。AIS组的平均HU和顶椎凸侧HU也较低，而顶椎凹侧HU略高。匹配后，AIS组的顶椎凸侧HU仍然较低，而顶椎凹侧HU较高。
AIS患者存在骨质减少，尤其是在凸侧。发现脊柱侧凸的严重程度与骨质流失的严重程度和双侧骨质减少不对称程度成正比。对骨质流失进行适当干预可能能够抑制脊柱侧凸的进展。
