| 青少年特发性脊柱侧弯胸腰椎生理曲度的影像学研究 |
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Received:December 26, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 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 Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310004, Zhejiang, China |
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| 陈妮桑 |
CHEN Ni-sang |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310004, Zhejiang, China |
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| 石国庆 |
SHI Guo-qing |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310004, Zhejiang, China |
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| 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 |
Department of Massage, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310004, Zhejiang, China |
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| 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 |
Department of Massage, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310004, Zhejiang, China |
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| 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 |
Department of Massage, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310004, Zhejiang, China |
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| 范炳华 |
FAN Bing-hua |
浙江中医药大学附属第三医院推拿科, 浙江 杭州 310004 |
Department of Massage, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310004, Zhejiang, China |
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| 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 Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310004, Zhejiang, China |
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| 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 |
Department of Massage, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310004, Zhejiang, China |
28588509@qq.com |
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| 期刊信息：《中国骨伤》2024年37卷，第1期，第26-32页 |
| DOI：10.12200/j.issn.1003-0034.20220493 |
| 基金项目:2021年浙江省中青年名中医项目(编号:sjzqn202106);范炳华国医名师传承工作室(编号:GZS2021009) |
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目的:探讨青少年特发性脊柱侧弯(adolescent idiopathic scoliosis,AIS)胸腰椎生理曲度变化情况以及不同类型侧弯之间胸腰椎生理曲度的差异。
方法:自2017年1月至2021年12月回顾性分析305例脊柱全长正侧位X线片的青少年患者,根据有无侧弯分为正常组和侧弯组。正常组179例,男79例,女100例;年龄10~18(12.84±2.10)岁。侧弯组126例,男33例,女93例;年龄10~18(13.92±2.20)岁。观察并比较两组Risser征、胸椎后凸角(thoracic kyphosis,TK)与腰椎前凸角(lumbar lordosis,LL),并分析比较不同性别、不同程度侧弯与不同节段侧弯TK值与LL值。
结果:侧弯组在女性比率(P=0.001)、年龄(P<0.001)方面均明显高于正常组;Risser征方面,正常组低级别骨化程度比率明显高于侧弯组(P=0.038)。侧弯组TK值明显小于正常组(P<0.001),而两组LL值比较,差异无统计学意义(P=0.147)。男性与女性之间比较,TK值与LL值差异无统计学意义。轻度侧弯TK值明显大于中度侧弯(P<0.05),但LL值比较,差异无统计学意义(P>0.05)。不同节段侧弯之间TK值与LL值比较,差异均无统计学意义(P>0.05)。
结论:胸椎与腰椎生理曲度均与性别无关;AIS患者胸椎生理曲度变小,但是腰椎生理曲度基本不变。轻度AIS患者的胸椎生理曲度大于中度AIS患者,但是腰椎生理曲度在轻中度患者之间几乎无差异,且与正常青少年相似。AIS患者胸腰椎生理曲度变化可能与脊柱前柱相对生长过快有关,其具体机制有待进一步研究。 |
| [关键词]:青少年特发性脊柱侧弯 胸椎后凸角 腰椎前凸角 生理曲度 |
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| Imaging study on thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis |
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Abstract:
Objective To observe the alteration of thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis(AIS) and the difference of physiological curvature between different types of scoliosis.
Methods A retrospective analysis was conducted on 305 adolescent patients taken full spine X-ray in our hospital from January 2017 to December 2021. The patients were divided into normal group and scoliosis group. The normal group was composed of 179 patients,79 males and 100 females,aged 10 to 18 years old with an average of (12.84±2.10) years old,with cobb agle less than 10 degrees. The scoliosis group was composed of 126 patients,33 males and 93 females,aged 10 to 18 years old with an average of (13.92±2.20) years old. The gender,age,Risser sign,thoracic kyphosis(TK) and lumbar lordosis(LL) in 2 groups were compared,and the TK and LL were also compared between different genders,different degrees of scoliosis and different segments of scoliosis.
Results The female ratio(P=0.001) and age (P<0.001) in scoliosis group were higher than them in normal group; the ratio of low-grade ossification was higher in normal group than in scoliosis group(P=0.038). TK was significantly smaller in scoliosis group than in normal group(P<0.001),but there was no significant difference in LL between the 2 groups(P=0.147). There were no significant difference in TK and LL between male and female. The TK was significantly bigger in mild AIS patients than in moderate AIS patients(P<0.05),but there was no significant difference in LL between mild and moderate patients(P>0.05). The TK and LL in different segments scoliosis were not found significant difference.
Conclusion The physiological curvature of thoracic and lumbar spine is independent of gender. The thoracic physiological curvature becomes smaller in AIS patients,but lumbar curvature remains unchanged. The thoracic physiological curvature in mild AIS patients is greater than that in moderate AIS patients,but the lumbar curvature is almost unchanged between mild and moderate scoliosis and is similar with that in normal adolescent. The alteration of thoracic and lumbar physiological curvature in AIS patients may be related to relative anterior spinal overgrowth,and the specific detailed mechanism needs to be further studied. |
| KEYWORDS:Adolescent idiopathic scoliosis Thoracic kyphosis Lumbar lordosis Physiological curvature |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张浩阳,陈妮桑,石国庆,叶鑫,李帅林,李晓明,范炳华,潘英森,应晓明.青少年特发性脊柱侧弯胸腰椎生理曲度的影像学研究[J].中国骨伤,2024,37(1):26~32 |
| 英文格式: | ZHANG Hao-yang,CHEN Ni-sang,SHI Guo-qing,YE Xin,LI Shuai-lin,LI Xiao-ming,FAN Bing-hua,PAN Ying-sen,YING Xiao-ming.Imaging study on thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(1):26~32 |
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