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目的利用EOS影像系统分析青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者的椎体轴面旋转角度与冠状面、矢状面和骨盆畸形间的关系。方法选择2015年9月至2016年2月,在我院拍摄的EOS脊柱全长X线片的AIS患者,共有49例纳入研究,使用ster EOS软件对脊柱全长X线片进行三维模型重建。根据主弯所在位置,获得冠状面Cobb’s角,轴面顶点椎体旋转、上椎旋转、末椎旋转、上椎椎体间轴面旋转和末椎椎体间轴面旋转角度,矢状面T_(4~12)后凸角和骨盆参数骨盆入射角、骨盆倾斜角。对各轴面旋转角度与冠状面Cobb’s角以及骨盆参数进行Pearson相关性分析。将胸主弯、胸腰段主弯和腰主弯的顶点椎体旋转角度分别与胸椎矢状面后凸角进行相关性分析。结果顶点椎体轴面旋转与Cobb’s角有较好的相关性(r=0.792,P<0.001),上椎旋转、末椎旋转、上椎椎体间轴面旋转和末椎椎体间轴面旋转分别与Cobb’s角有轻、中度的相关性(r=0.419,P=0.003;r=0.320,P=0.025;r=0.366,P<0.01;r=0.345,P=0.015)。除顶点椎体轴面旋转与骨盆倾斜角有轻度相关性外(r=0.330,P<0.021),其余脊柱轴面与骨盆参数均无明显相关性。主胸椎侧凸组、胸腰段侧凸组和腰椎侧凸组顶点椎体旋转角度与T_(4~12)后凸角均无明显相关性。结论椎体轴面旋转角度与脊柱冠状面Cobb’s角之间存在密切的联系,但可能与胸椎后凸角和骨盆畸形并无明显关系。
Objective To analyze the relationship between coronal plane, sagittal plane and pelvic deformity by using EOS imaging system in adolescent idiopathic scoliosis (AIS) patients. METHODS: From September 2015 to February 2016, 49 patients with AIS of spine full-length X-ray of spine taken in our hospital were included in the study. Three-dimensional reconstruction of the spine full-length X-ray was performed using ster EOS software. According to the position of the main curve, the coronal Cobb’s angle, vertex vertex rotation, upper vertebral rotation, end rotation, intervertebral rotation of the intervertebral body and axial rotation of the vertebral body were obtained. The sagittal plane T_ (4 ~ 12) kyphosis and pelvic parameters pelvis incidence angle, pelvis tilt angle. Pearson correlation analysis was performed between the rotation angles of each axial plane and the coronal Cobb’s angle and pelvis parameters. The correlation analysis of vertebral rotation angle of thoracolumbar main curve, thoracolumbar segment main curve and lumbar main curve with sagittal plane sagittal kyphosis angle respectively. Results There was a good correlation between the rotation of vertex vertex and Cobb’s angle (r = 0.792, P <0.001). The rotation of upper vertebral body, the rotation of the end vertebra, the axial rotation of the intervertebral body and the axial plane of the vertebral body Rotation correlated mildly with moderately with Cobb’s angle (r = 0.419, P = 0.003; r = 0.320, P = 0.025; r = 0.366, P <0.01; r = 0.345, P = 0.015). There was no significant correlation between axial plane and pelvic parameters of the other vertebral bodies except that the rotation of the apical vertebra was slightly correlated with the pelvic tilt (r = 0.330, P <0.021). There was no significant correlation between vertebral rotation angle and T_ (4 ~ 12) kyphosis angle in the major thoracic scoliosis group, thoracolumbar scoliosis group and lumbar scoliosis group. Conclusion There is a close relationship between the rotational angle of the vertebral body and the coronal Cobb’s angle of the vertebral body, but it may not have a significant relationship with the thoracic kyphosis and pelvic deformity.