青少年特发性脊柱侧弯Cobb角与直线棘突角相关性分析
摘要点击次数: 692   全文下载次数: 311   投稿时间:2023-04-22    
作者Author单位AddressE-Mail
应晓明 YING Xiao-ming 浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 Tuina Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China  
吕立江 LYU Li-jiang 浙江中医药大学第三临床医学院, 浙江 杭州 310053 The 3rd Clinical Medical College of ZCMU, Hangzhou 310053, Zhejiang, China  
张浩阳 ZHANG Hao-yang 浙江中医药大学第三临床医学院, 浙江 杭州 310053 The 3rd Clinical Medical College of ZCMU, Hangzhou 310053, Zhejiang, China  
潘英森 PAN Ying-sen 浙江中医药大学第三临床医学院, 浙江 杭州 310053 The 3rd Clinical Medical College of ZCMU, Hangzhou 310053, Zhejiang, China  
李帅林 LI Shuai-lin 浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 Tuina Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China  
李晓明 LI Xiao-ming 浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 Tuina Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China  
叶鑫 YE Xin 浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 Tuina Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China  
杨超 YANG Chao 浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 Tuina Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China  
何丽兰 HE Li-lan 浙江中医药大学附属第三医院超声科, 浙江 杭州 310004 Ultrasonic Department, the 3rd Hospital Affiliated to Chejiang University of Trditional Chinese Medicine, Hangzhou 310004, Zhejiang, China 1527784869@qq.com 
期刊信息:《中国骨伤》2023年,第36卷,第10期,第949-953页
DOI:10.12200/j.issn.1003-0034.2023.10.008
基金项目:2022年度浙江省"尖兵""领雁"研发攻关计划项目(编号:2022C03123);2021年浙江省中青年名中医项目(编号:sjzqn202106);2023年度浙江省中医药科技计划项目(编号:2023ZF024)
中文摘要:

目的:分析轻中度青少年特发性脊柱侧弯(adolescent idiopathic scoliosis,AIS)患者Cobb角与X线片直线棘突角(spinous process angle,SPA)、体表直线SPA相关性,探讨直线SPA评估脊柱侧弯的可能性。

方法:Cobb角与X线片直线棘突角相关性研究为单中心回顾性研究,纳入自2019年1月至2021年12月脊柱全长正位X线片的AIS患者,测量患者直线SPA与Cobb角,并对两者进行相关性分析。Cobb角与体表直线SPA相关性研究为前瞻性研究,纳入自2022年12月1日至2022年12月9日就诊的AIS患者,测量Cobb角与站立位下体表直线SPA,并对两者进行相关性分析。

结果:回顾性研究中共纳入113例AIS患者,男26例,女87例,年龄10~18(14.02±2.16)岁;轻度AIS患者71例,中度AIS患者42例。AIS患者Cobb角与直线SPA存在明显负相关(r=-0.564,P<0.001),两者线性回归方程为:Cobb角=169.444-0.878×SPA;轻度侧弯患者Cobb角与直线SPA存在明显负相关(r=-0.269,P=0.012),其线性回归方程为:Cobb角=46.832-0.185×SPA;中度侧弯患者Cobb角与直线SPA也具有明显相关性(r=-0.417,P=0.003),其线性回归方程为:Cobb角=113.889-0.516×SPA。前瞻性研究纳入38例患者,Cobb角11.3°~36.0°(18.70±6.98)°;体表直线SPA 162.1°~177.7°(170.34±4.57)°;两者存在明显负相关(r=-0.651,P<0.001),其线性回归方程为:Cobb角=187.91-0.99×SPA。

结论:X线片直线SPA、体表直线SPA与Cobb角均呈明显负相关,其相关程度略低于曲线SPA,为中等强度相关;两者回归方程拟合性欠佳,不适合用于脊柱侧弯的诊断;但是直线SPA可能适合用于评估自身对照的治疗效果以及脊柱柔韧性。
【关键词】青少年特发性脊柱侧弯  棘突角  Cobb角  相关性分析
 
Correlation analysis of Cobb angle and linear spinous process angle in adolescent idiopathic scoliosis
ABSTRACT  

Objective To analyze the correlation between Cobb angle and spinous process angle (SPA) on X-ray film and body surface in patients with mild to moderate adolescent idiopathic scoliosis(AIS). To explore the possibility of linear SPA to assess scoliosis.

Methods Retrospective study for correlation of Cobb angle and linear SPA on X-ray film. AIS patients treated and taken full spine anteroposterior X-ray from January 2019 to December 2021 were analyzed correlation of Cobb angle and linear SPA on X-ray film. Prospective study for correlation of Cobb angle and body linear SPA. AIS patients treated and taken full spine anteroposterior X-ray from December 1 to December 9 this year were analyzed correlation of Cobb angle and body linear SPA.

Results A total of 113 AIS patients with age an average of (14.02±2.16) years old(ranged from 10 to 18 years old) were recruited in retrospective study,involving 26 males and 87 females;there were 71 patients with mild AIS and 42 patients with moderate AIS. Cobb angle in AIS patients was significantly inversely associated with SPA(r=-0.564,P<0.001),the linear regression equation was:Cobb angle=169.444-0.878×SPA. Cobb angles in patients with mild scoliosis were significantly and inversely associated with SPA(r=-0.269,P=0.012),the linear regression equation was:Cobb angle=46.832-0.185×SPA. Cobb angles in patients with moderate scoliosis were also clearly correlated with SPA(r=-0.417,P=0.003),the linear regression equation was:Cobb angle=113.889-0.516×SPA. Thirty-eight patients were recruited in prospective study. The mean Cobb angle and body linear SPA were(18.70±6.98)°,ranged from 11.3° to 36.0° and (170.34±4.57)°,ranged from 162.1° to 177.7° respectively. There was significantly negative correlation(r=-0.651,P<0.001),the linear regression equation is:Cobb angle=187.91-0.99×SPA.

Conclusion Linear SPA on X-ray film or on the body was significantly negatively correlated with Cobb angles,but the regression equation fits poorly,so it's not suitable for diagnosis of scoliosis;however,linear SPA is appropriate for self-controlled assessment of scoliotic therapy or for dynamic assessment of spinal flexibility.
KEY WORDS  Adolescent idiopathic scoliosis  Spinous process angle  Cobb angle  Correlation analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:应晓明,吕立江,张浩阳,潘英森,李帅林,李晓明,叶鑫,杨超,何丽兰.青少年特发性脊柱侧弯Cobb角与直线棘突角相关性分析[J].中国骨伤,2023,36(10):949~953
英文格式:YING Xiao-ming,LYU Li-jiang,ZHANG Hao-yang,PAN Ying-sen,LI Shuai-lin,LI Xiao-ming,YE Xin,YANG Chao,HE Li-lan.Correlation analysis of Cobb angle and linear spinous process angle in adolescent idiopathic scoliosis[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(10):949~953
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