正常个体和中度脊柱侧弯患者的冠状面排列:标准值、随年龄的变化以及与矢状面排列的比较。
Coronal alignment in normal individuals and moderate scoliosis: Normative values, variation with age and comparison with sagittal alignment.
作者信息
Gharbi Ahmed, Obeid Ibrahim, Larrieu Daniel, Boissière Louis, Huneidi Maxime, Lamotte-Paulet Pablo, Tamir Mekki, Aleman Carlos, Charles Yann Philippe
机构信息
Department of Spine Surgery, Strasbourg University Hospital, Strasbourg, France.
Spine Surgery Unit 1, Bordeaux University Hospital, Bordeaux, France.
出版信息
Brain Spine. 2024 Oct 11;4:103917. doi: 10.1016/j.bas.2024.103917. eCollection 2024.
INTRODUCTION
Global coronal alignment is mainly assessed by C7 plumbline and central sacral vertical line (CSVL), pelvic obliquity and shoulder alignment. A detailed analysis is mandatory when treating spinal deformity. It remains unclear to what extent mild scoliosis influences global coronal alignment.
RESEARCH QUESTION
The objective was to define a comprehensive set of coronal alignment parameters and to investigate differences between individuals without spinal deformity and with mild scoliosis. The relationship between coronal and sagittal alignment and the influence of age were studied.
METHODS
Radiographs of 236 normal individuals (Group N) and 140 patients with scoliosis <35° (Group S) were prospectively collected. Coronal parameters were femoral head distance and angle, pelvic obliquity, Maloney angle, L4 and L5 inclinations, coronal T1 pelvic angle, C7-CSVL and odontoid CSVL offset, coracoid distance and angle. Sagittal cervical, spinopelvic, thoracolumbar and global parameters were measured.
RESULTS
There was no significant difference between groups N and S for coronal parameters, except for L4 and L5 inclinations with a mean difference of 3,3° (p < 0,001). Global coronal alignment kept constant throughout age groups in N and S groups. Sagittal parameters varied with age: C2-C7 lordosis (p < 0,001), T1-T12 kyphosis (p < 0,001), pelvic incidence (p < 0,001). There was no correlation between global coronal and sagittal alignment: R-values ranging from -0.2 to 0.2.
CONCLUSION
Global coronal parameters were comparable in normal individuals and in scoliosis <35°. Coronal plane parameters were not influenced by age. Sagittal plane parameters varied significantly with age. There was no direct link between coronal et sagittal alignment.
引言
整体冠状面排列主要通过C7铅垂线和骶骨中央垂直线(CSVL)、骨盆倾斜度和肩部排列来评估。治疗脊柱畸形时必须进行详细分析。目前尚不清楚轻度脊柱侧弯在多大程度上影响整体冠状面排列。
研究问题
目的是定义一套全面的冠状面排列参数,并研究无脊柱畸形个体与轻度脊柱侧弯个体之间的差异。研究了冠状面和矢状面排列之间的关系以及年龄的影响。
方法
前瞻性收集了236名正常个体(N组)和140名脊柱侧弯<35°的患者(S组)的X线片。冠状面参数包括股骨头距离和角度、骨盆倾斜度、马隆尼角、L4和L5倾斜度、冠状面T1骨盆角、C7-CSVL和齿突CSVL偏移、喙突距离和角度。测量矢状面颈椎、脊柱骨盆、胸腰椎和整体参数。
结果
N组和S组在冠状面参数上无显著差异,除了L4和L5倾斜度,平均差异为3.3°(p<0.001)。N组和S组的整体冠状面排列在各年龄组中保持恒定。矢状面参数随年龄变化:C2-C7前凸(p<0.001)、T1-T12后凸(p<0.001)、骨盆倾斜度(p<0.001)。整体冠状面和矢状面排列之间无相关性:R值范围为-0.2至0.2。
结论
正常个体和脊柱侧弯<35°患者的整体冠状面参数具有可比性。冠状面参数不受年龄影响。矢状面参数随年龄显著变化。冠状面和矢状面排列之间没有直接联系。