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先天性脊柱侧凸美学指标与影像学指标的相关性研究

Correlation with cosmetic and radiographic parameters in vertebral segmentation failure of congenital scoliosis

摘要:

目的:探讨分节障碍型先天性脊柱侧凸(congenital scoliosis,CS)患者的美学指标与影像学指标的相关性,以及美学指标的临床意义。方法:回顾性分析27例分节障碍型CS患者的临床及影像学资料,所有患者均摄正、侧位全脊柱X线片,以及自然站立位背部及前屈位的大体照片。大体照片测量以下7个美学指标:肩部面积指数1(shoulder area index 1,SAI1)、肩部面积指数2(shoulder area index 2,SAI2)、腰部面积指数(lumbar area index,LAI)、肩角(shoulder angle,α 1)、腋窝角(axilla angle,α 2)、左右腰角差(right and left waist angle difference,RLWAD)和剃刀背指数(hump index);同时在患者术前X线片上测量7个影像学指标:影像肩高差(radiographic shoulder height difference,RSHD)、T 1倾斜(T 1 tilt)、第一肋角(first rib angle,FRA)、锁骨角(clavicle angle,CA)、锁骨肋骨交点高度差(clavicle-rib cage intersection,CRCI)、锁骨胸腔角度差(clavicle chest cage angle difference,CCAD)和Cobb角(Cobb angle)。对美学指标与影像学指标进行Pearson相关性分析。 结果:LAI与CCAD有明显相关性( P=0.020),但其相关系数仅为-0.44。SAI1与各影像学指标之间相关系数范围为-0.17~0.53,其中与RSHD、T 1倾斜、FRA、CA、CRCI呈明显相关。SAI2与各影像学指标间的相关系数范围为-0.16~0.53,其中与RSHD、CA、CRCI呈明显相关,但所有相关系数均低于0.6。其余美学指标与影像学指标的相关系数也均低于0.6。 结论:影像学指标并不能准确地反映分节障碍型CS患者的美学外观,在评估患者整体外观时应将美学指标作为重要的评价组成部分。

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abstracts:

Objective:To investigate the correlations between cosmetic and radiographic parameters in patients with congenital scoliosis (CS) with vertebral segmentation failureand the clinical implication of cosmetic parameters.Methods:A total of 27 CS patients were retrospectively reviewed. Anteroposterior and lateral radiographs of the entire spine was taken. Simultaneously, photos were taken from the back in natural standing position and standing forward bending position. Seven cosmetic parameters were measured on the photographs: shoulder area index 1 (SAI1), shoulder area index 2 (SAI2), lumbar area index (LAI), shoulder angle (α 1), axilla angle (α 2), right and left waist angle difference (RLWAD) and hump index. Also, seven radiographic parameterswere measured on the radiographs: radiographic shoulder height difference (RSHD), T 1 tilt, first rib angle (FRA), clavicle angle (CA), clavicle-rib cage intersection (CRCI), clavicle chest cage angle difference (CCAD) and Cobb's angle. The correlation between cosmetic parameters and radiographic parameters was analyzed by Pearson correlation coefficient. Results:Of the 27 patients, 4 were males and 23 were females, with a mean of age 14.0±2.6 years (range 11-18 years). The apical vertebra ranged from T 5 to T 11. LAI was significantly correlatedwith CCAD, but correlation coefficient was only -0.44. The range of correlation coefficientsbetween SAI1 and all radiographic parameters was -0.17 to 0.53, and the range of correlation coefficients between SAI2 and all radiographic parameters was -0.16 to 0.53. However, all correlation coefficients were less than 0.56. Conclusion:Radiographic parameters cannot reflect cosmetic appearances of CS patients with vertebral segmentation failures accurately. More attention should be paid to cosmetic parameters in the evaluation of patients' appearances.

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作者: 刘昌伟 [1] 朱泽章 [1] 许彦劼 [2] 胡宗杉 [2] 凌宸 [1] 钱至恺 [1] 李劼 [2] 刘臻 [1] 邱勇 [1]
期刊: 《中华骨科杂志》2022年42卷11期 715-721页 ISTICPKUCSCD
栏目名称: 临床研究
DOI: 10.3760/cma.j.cn121113-20211222-00735
发布时间: 2022-07-31
基金项目:
国家自然科学基金 十三五南京市卫生人才培养计划 National Natural Science Foundation of China Nanjing Medical Science and Technique Development Foundation
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