青少年特发性脊柱侧凸患者上颈椎序列变化特点及各参数间的相关性

发布时间：2018-07-01 15:22

本文选题：青少年特发性脊柱侧凸 + 上颈椎序列　；参考：《中国脊柱脊髓杂志》2017年02期

【摘要】：目的:测量青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者上颈椎序列参数,探讨各参数间的相关关系及其在维持前视平衡中所起的作用。方法:回顾性分析2014年1月~2016年1月期间就诊的196例AIS患者,排除其中资料不全者、接受过治疗者、患有影响脊柱序列疾病者以及上胸段脊柱侧凸累及颈段者,共有103例患者纳入研究,其中男26例,女77例,年龄10~17岁(14.66±2.31岁)。在脊柱侧位X线片上测量颈椎Cobb角(cervical Cobb angle,CCA)、C0-C2角(occiput-C2 angle)、C1-C2角(C1-C2 angle)、硬腭-C2角(palatum-C2 angle)、C2椎体轮廓线(C2 vertebra contour angle)、C1-C7矢状面轴向距离(C1-C7 SVA)、T2倾斜角(T2 sagittal tilt)。根据Lenke胸椎修正分型(修正+、修正N、修正-)将患者分为(+)、N、(-)3组,比较各组间参数的差异性以及各参数间的相关性。结果:颈椎Cobb角10.29°±8.65°;C0-C2角13.86°±8.33°;C1-C2角25.61°±9.17°;硬腭-C2角12.06°±8.91°;C2椎体轮廓线98.43°±6.75°;C1-C7矢状面轴向距离28.41±10.69mm;T2倾斜角10.73°±8.11°。在Lenke胸椎修正分组中颈椎Cobb角及T2倾斜角在各组间有统计学差异(P0.05)。C0-C2角、C1-C2角、C1-C7矢状面轴向距离、硬腭-C2角相互之间有显著性正相关(P0.01)。结论:AIS患者的T2倾斜角很大程度上受到T5~T12后凸的影响。当AIS患者的颈椎在矢状位发生位移减少时,机体可通过减小C1-C2角来维持前视平衡。
[Abstract]:Objective: to measure the parameters of upper cervical spine sequence in adolescent idiopathic scoliosis (adolescent idiopathic) and to explore the correlation between these parameters and the role of these parameters in maintaining the balance of anterior vision. Methods: 196 patients with AIS from January 2014 to January 2016 were retrospectively analyzed, including incomplete data, patients who received treatment, patients with diseases affecting the sequence of spine, and patients with upper thoracic scoliosis involving neck segment. A total of 103 patients were included in the study, including 26 males and 77 females, aged 10 to 17 years (14.66 卤2.31 years). Measurement of cervical Cobb angle (cervical Cobb angle CCA) and C _ 1-C _ 2 angle (C _ 1-C _ 2 angle), hard palatum-C _ 2 angle) C _ 2 vertebra contour angle) C _ 1-C _ 7 sagittal distance (C _ 1-C _ 7SVA) T _ 2 obliquity angle (T _ 2 sagittal tilt).) The patients were divided into three groups according to the modified classification of Lenke thoracic vertebrae (modified, modified N-, modified -). The difference of parameters and the correlation between them were compared. Results: the cervical Cobb angle was 10.29 掳卤8.65 掳C _ 0-C _ 2 angle 13.86 掳卤8.33 掳C _ 1-C _ 2 angle 25.61 掳卤9.17 掳, the hard palate C _ 2 angle 12.06 掳卤8.91 掳C _ 2 vertebral contours 98.43 掳卤6.75 掳C _ 1-C _ 7 axial distance 28.41 卤10.69 mm T _ 2 angle 10.73 掳卤8.11 掳. There were significant differences in the Cobb angle and T2 angle between the two groups (P0.05). C0-C2 angle C1-C2 angle C1-C7 sagittal plane axial distance and hard palate C2 angle were positively correlated with each other (P0.01). Conclusion the T 2 tilt angle of AIS patients is greatly affected by T 5 T 12 kyphosis. When the cervical vertebrae displacements in AIS patients decrease in sagittal position, the body can maintain the forward balance by reducing the C _ 1-C _ 2 angle.
【作者单位】：温州医科大学附属黄岩医院骨科;温州医科大学附属第二医院骨科;
【基金】：国家自然科学基金面上项目(编号:81371988)
【分类号】：R726.8

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