Hilibrand A S, Tannenbaum D A, Graziano G P, Loder R T, Hensinger R N
Section of Orthopaedic Surgery, University of Michigan Hospitals, Ann Arbor 48109, USA.
J Pediatr Orthop. 1995 Sep-Oct;15(5):627-32. doi: 10.1097/01241398-199509000-00015.
To assess the sagittal orientation of the cervical and thoracolumbar spine, 38 adolescents with idiopathic scoliosis were studied. The C7 plumb line and Cobb angles from C2-6, T1-12, and L1-S1 were measured on preoperative films. Lateral radiographs with > 1-year follow-up after surgical correction were available for the same measurements in 28 patients. The preoperative curve from C2-6 was 6 +/- 11 degrees of kyphosis. There was a significant correlation between the loss of thoracic kyphosis and the development of cervical kyphosis for the entire group preoperatively (p = 0.009). Postoperatively, cervical kyphosis increased to 11 +/- 9 degrees at 1-year follow-up (p = 0.05). There was no progression of cervical kyphosis in patients with "thoracic hypokyphosis" (kyphosis < 20 degrees). Cervical kyphosis increased in patients with "normal" thoracic kyphosis (20-40 degrees) and in patients with hyperkyphosis (kyphosis > 40 degrees) after surgery, despite preservation of thoracolumbar sagittal contour. There were no significant differences between the sagittal contour of patients treated with Cotrel-Dubousset or Harrington instrumentation.
为评估颈椎和胸腰椎矢状面的方向，对38例青少年特发性脊柱侧凸患者进行了研究。在术前X线片上测量C7铅垂线以及C2 - 6、T1 - 12和L1 - S1的Cobb角。28例患者在手术矫正后有超过1年随访的侧位X线片，可用于相同测量。术前C2 - 6的曲度为后凸6±11度。术前整个组中胸椎后凸的丢失与颈椎后凸的发展之间存在显著相关性（p = 0.009）。术后，在1年随访时颈椎后凸增加到11±9度（p = 0.05）。“胸椎后凸减小”（后凸<20度）的患者颈椎后凸没有进展。尽管保留了胸腰椎矢状轮廓，但术后“正常”胸椎后凸（20 - 40度）的患者和后凸增大（后凸>40度）的患者颈椎后凸增加。使用Cotrel - Dubousset或Harrington器械治疗的患者矢状轮廓之间没有显著差异。
