Ono T
Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Oct;69(10):915-26.
Ihe three-dimensional back surface shape of 504 patients with untreated idiopathic scoliosis was studied using moiré topography. A new system for the quantitative analysis of moiré pictures was developed with the aid of a still video photo system and microcomputer system. With these systems, the outcome of the analysis can be obtained immediately at the clinical scene. Using a positioning device that restrained the movement of the patient's pelvis at the time of taking the moiré picture, the reproducibility error was very small. The relationship of the parameters from the surface measurements with the radiographic appearance was then examined. The hump sum (HS), that is the sum total of the hump indices on three levels of the back was used as an index that represented the severity of the trunk deformity. It was possible to estimate objectively from HS, the correction in trunk deformity obtained after treatment. There was a relatively weak but statistically significant number of cases in which the degree of hump and that of the lateral curvature did not agree. Those within the range of one standard deviation from the regression line were defined as the standard rotation group, and those out of this range as the nonstandard rotation group. In the standard rotation group, the progression in curvature could be detected by moiré analysis so that exposure to radiation could be reduced. In the nonstandard rotation group, radiographic examination remained necessary, although the magnitude of the trunk deformity itself could be estimated more accurately by HS. The discrepancy between the HS and the Cobb angle suggested that scoliosis and rib deformity were independent from each other, and therefore they should be evaluated separately.
采用云纹摄影术对504例未经治疗的特发性脊柱侧凸患者的三维后表面形状进行了研究。借助静态视频摄影系统和微机系统开发了一种新的云纹图片定量分析系统。利用这些系统,可以在临床现场立即获得分析结果。在拍摄云纹图片时使用限制患者骨盆运动的定位装置,再现性误差非常小。然后检查了表面测量参数与X线表现之间的关系。驼峰总和(HS),即背部三个水平的驼峰指数总和,被用作代表躯干畸形严重程度的指标。从HS可以客观地估计治疗后躯干畸形的矫正情况。有相当数量的病例,驼峰程度与侧方弯曲程度不一致,虽然这种情况相对较弱,但具有统计学意义。那些在回归线一个标准差范围内的被定义为标准旋转组,而那些超出此范围的则为非标准旋转组。在标准旋转组中,通过云纹分析可以检测到弯曲的进展,从而减少辐射暴露。在非标准旋转组中,虽然通过HS可以更准确地估计躯干畸形的程度,但X线检查仍然是必要的。HS与Cobb角之间的差异表明脊柱侧凸和肋骨畸形相互独立,因此应分别进行评估。