叶峰;胡建新;施建雄;黄博;邱浩;初同伟;

• 1:第三军医大学附属新桥医院骨科

摘要(Abstract)：

[目的]青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者术前后矢状位的脊柱骨盆参数做相关性研究,并比较术前、后脊柱骨盆参数的改变。[方法]回顾性分析39例经后路椎弓根螺钉固定融合的AIS患者。在脊柱全长侧位X线片上测量术前后的骨盆参数,包括:骨盆入射角(pelvic incidence,PI),骨盆倾斜角(pelvic tilt,PT),骶骨倾斜角(sacral slope,SS);脊柱参数包括:腰椎前凸角(lumbar lordosis,LL),胸椎后凸角(thoracic kyphosis,TK),腰椎融合节段以下前凸角(lumbar lordosis below fusion,LL below fusion),腰椎融合节段内前凸角(lumbar lordosis within fusion,LL within fusion)等参数。用Pearson法分析各个参数术前、术后的相关系数。对各个参数术前后的改变经正态检验后,使用t检验或非参数检验。[结果]相关系数分析中P<0.01为差异有统计学意义。PI与SS、LL术前后强烈相关(r>0.5),与PT术前中度相关(0.30.5)。TK无论是术前还是术后均与其他参数无相关性。依据TK大小分组(TK<20°21例;20°

关键词(KeyWords)： 青少年特发性脊柱侧凸;脊柱骨盆参数

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 叶峰;胡建新;施建雄;黄博;邱浩;初同伟;

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参考文献(References)：

• [1]Glassman SD,Bridwell K,Dimar JR,et al.The impact of positive sagittal balance in adult spinal deformity[J].Spine(Phila Pa 1976),2005,30(18):2024-2029.
• [2]Schwab FJ,Smith VA,Biserni M,et al.Adult scoliosis:a quantitative radiographic and clinical analysis[J].Spine(Phila Pa 1976),2002,27(4):387-392.
• [3]Lafage V,Schwab F,Patel A,et al.Pelvic tilt and truncal inclination:two key radiographic parameters in the setting of adults with spinal deformity[J].Spine(Phila Pa 1976),2009,34(17):599-606.
• [4]Legaye J,Duval-Beaupere G,Hecquet J,et al.Pelvic incidence:a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves[J].Europ Spine J,1998,7(2):99-103.
• [5]Duval-Beaupere G,Schmidt C,Cosson P.A barycentremetric study of the sagittal shape of spine and pelvis:the conditions required for an economic standing position[J].Ann Biomed Eng,1992,20(4):451-462.
• [6]Glassman SD,Berven S,Bridwell K,et al.Correlation of radiographic parameters and clinical symptoms in adult scoliosis[J].Spine(Phila Pa 1976),2005,30(6):682-688.
• [7]Roussouly P,Gollogly S,Noseda O,et al.The vertical projection of the sum of the ground reactive forces of a standing patient is not the same as the C7plumb line:a radiographic study of the sagittal alignment of 153 asymptomatic volunteers[J].Spine(Phila Pa 1976),2006,31(11):320-325.
• [8]Mac-Thiong JM,Berthonnaud E,Dimar JN,et al.Sagittal alignment of the spine and pelvis during growth[J].Spine(Phila Pa 1976),2004,29(15):1642-1647.
• [9]Vaz G,Roussouly P,Berthonnaud E,et al.Sagittal morphology and equilibrium of pelvis and spine[J].Europ Spine J,2002,11(1):80-87.
• [10]Mac-Thiong JM,Labelle H,Berthonnaud E,et al.Sagittal spinopelvic balance in normal children and adolescents[J].Europ Spine J,2007,16(2):227-234.
• [11]Mac-Thiong JM,Labelle H,Charlebois M,et al.Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type[J].Spine(Phila Pa 1976),2003,28(13):1404-1409.
• [12]Yong Q,Zhen L,Zezhang Z,et al.Comparison of sagittal spinopelvic alignment in Chinese adolescents with and without idiopathic thoracic scoliosis[J].Spine(Phila Pa 1976),2012,37(12):714-720.
• [13]Upasani VV,Tis J,Bastrom T,et al.Analysis of sagittal alignment in thoracic and thoracolumbar curves in adolescent idiopathic scoliosis:how do these two curve types differ[J].Spine(Phila Pa 1976),2007,32(12):1355-1359.
• [14]陈峰,沈建雄,邱贵兴.青少年特发性脊柱侧凸骨盆参数与脊柱矢状面参数的相关性[J].中华医学杂志,2013,39(7):487-490.
• [15]de Jonge T,Dubousset JF,Illes T.Sagittal plane correction in idiopathic scoliosis[J].Spine(Phila Pa 1976),2002,27(7):754-760.
• [16]Hagglund G,Karlberg J,Willner S.Growth in girls with adolescent idiopathic scoliosis[J].Spine(Phila Pa 1976),1992,17(1):108-111.
• [17]Jackson RP,Mc Manus AC.Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age,sex,and size.A prospective controlled clinical study[J].Spine(Phila Pa 1976),1994,19(14):1611-1618.
• [18]Clement JL,Geoffray A,Yagoubi F,et al.Relationship between thoracic hypokyphosis,lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis[J].Europ Spine J,2013,22(11):2414-2420.
• [19]Tanguay F,Mac-Thiong JM,de Guise JA,et al.Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis[J].Europ Spine J,2007,16(4):531-536.
• [20]Cochran T,Irstam L,Nachemson A.Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by harrington rod fusion[J].Spine(Phila Pa 1976),1983,8(6):576-584.
• [21]Hayes MA,Tompkins SF,Herndon WA,et al.Clinical and radiological evaluation of lumbosacral motion below fusion levels in idiopathic scoliosis[J].Spine(Phila Pa 1976),1988,13(10):1161-1167.
• [22]Ghiselli G,Wang JC,Hsu WK,et al.L5S1segment survivorship and clinical outcome analysis after L4、5isolated fusion[J].Spine(Phila Pa 1976),2003,28(12):1275-1280.
• [23]Kumar MN,Baklanov A,Chopin D.Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion[J].Europ Spine J,2001,10(4):314-319.
• [24]Rinella A,Bridwell K,Kim Y,et al.Late complications of adult Idiopathic scoliosis primary fusions to L4and above:the effect of age and distal fusion level[J].Spine(Phila Pa 1976),2004,29(3):318-325.