Cheng J C, Guo X
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T. Hong Kong.
Spine (Phila Pa 1976). 1997 Aug 1;22(15):1716-21. doi: 10.1097/00007632-199708010-00006.
A cross-sectional study to assess the lumbar spinal and proximal femoral bone mineral density in girls aged 12, 13, or 14 years with adolescent idiopathic scoliosis and to compare them with bone mineral densities of an age-matched control group.
To determine whether there is an association of osteopenia with idiopathic scoliosis, to compare bone mineral density in patients with scoliosis in different age groups with healthy controls, and to correlate bone mineral density with scoliotic parameters, including the pattern and magnitude of the curve.
Routine radiographs allow very limited assessment of osteopenia. Therefore, only a few studies have compared osteopenia in patients with scoliosis with that in healthy individuals. New techniques allow a more reliable quantification of the bone mineral state in adolescent idiopathic scoliosis. Available series in the literature either had a small sample population with inadequate controls or examined a large age range.
Using a dual energy x-ray absorptiometer, bone mineral density was measured in the predominant trabecular bone area, i.e., the lumbar spine (L2-L4) and bilateral proximal femur, in 81 girls aged 12, 13, or 14 years old with idiopathic scoliosis of various degrees of severity. Results were compared with those of 220 age-matched healthy control girls.
In all three age groups, scoliotic patients had significantly lower bone mineral density in all measured regions than that in the control individuals (student's t test). Sixty-eight percent of the scoliotic individuals had a significantly reduced bone mineral density. Differences in bone mineral density between bilateral hips (paired t test) were not statistically significant either in scoliotic patients or in healthy control individuals. No differences in body weight, body height, or menarche status were found between the scoliotic and control individuals. Correlation studies showed that, in scoliotic patients, the values of bone mineral density did not correlate with the curve degree or curve pattern.
There is a persistently lower bone mineral density in patients between 12 years and 14 years of age with idiopathic scoliosis. The decreased bone mineral density occurred in patients with idiopathic scoliosis before the age of 12 years, with no further progression from the age 12 to age 14, and did not correlate with the scoliosis degree or pattern. These findings suggest that the osteopenia in idiopathic scoliosis may be related to the primary etiology of the disease rather than secondary to the asymmetrical mechanical forces associated with the back deformities.
一项横断面研究，旨在评估12、13或14岁患有青少年特发性脊柱侧弯的女孩的腰椎和股骨近端骨密度，并将其与年龄匹配的对照组的骨密度进行比较。
确定骨质减少与特发性脊柱侧弯之间是否存在关联，比较不同年龄组脊柱侧弯患者与健康对照者的骨密度，并将骨密度与脊柱侧弯参数（包括侧弯的类型和程度）相关联。
常规X线片对骨质减少的评估非常有限。因此，只有少数研究比较了脊柱侧弯患者与健康个体的骨质减少情况。新技术能更可靠地量化青少年特发性脊柱侧弯患者的骨矿物质状态。文献中的现有系列研究要么样本量小且对照不足，要么研究的年龄范围较大。
使用双能X线吸收仪，测量了81名年龄在12、13或14岁、患有不同严重程度特发性脊柱侧弯的女孩的主要小梁骨区域，即腰椎（L2-L4）和双侧股骨近端的骨密度。将结果与220名年龄匹配的健康对照女孩的结果进行比较。
在所有三个年龄组中，脊柱侧弯患者在所有测量区域的骨密度均显著低于对照组（学生t检验）。68%的脊柱侧弯患者骨密度显著降低。脊柱侧弯患者和健康对照个体双侧髋部之间的骨密度差异（配对t检验）均无统计学意义。脊柱侧弯患者和对照个体在体重、身高或初潮状态方面未发现差异。相关性研究表明，在脊柱侧弯患者中，骨密度值与侧弯程度或侧弯类型无关。
12岁至14岁的特发性脊柱侧弯患者骨密度持续较低。骨密度降低发生在12岁之前患有特发性脊柱侧弯的患者中，从12岁到14岁没有进一步进展，且与脊柱侧弯程度或类型无关。这些发现表明，特发性脊柱侧弯中的骨质减少可能与疾病的原发性病因有关，而非继发于与背部畸形相关的不对称机械力。
