胸腰椎相邻节段矢状曲度X线片不同测量方法的对比研究

Comparative study of radiographic measurements on sagittal plane curves in adjacent segments of tho?鄄racolumbar spine

中文关键词:  胸腰椎  矢状曲度  相邻节段  X线

英文关键词:Ｔhoracolumbar spine  Ｓagittal plane curve  Ａdjacent segment  X-ray

中文摘要:

  【摘要】 目的：对比研究X线片上3种测量胸腰椎相邻节段矢状曲度方法的准确性，为临床应用提供放射学依据。方法：选取脊柱干燥标本共计6具，以不同投照方式行胸腰椎侧位X线摄片共计42次。选择79例正常人行站立位标准侧位X线摄片。将上述资料在数字工作站上用以下3种方式测量胸腰椎相邻节段矢状曲度：①失真代偿X线分析法（DCRA法）；②测量相邻椎体上、下终板垂线夹角（Cobb法1）；③测量相邻椎体上终板垂线夹角（Cobb法2），将上述数据进行统计学比较。结果：脊柱标本3种测量方法两两对比，投照椎体轴向逆时针或顺时针旋转时差异有显著性（P<0.05）。脊柱标本不同投照方式测量结果对比，DCRA法测量相邻节段矢状曲度无差异（P>0.05），而Cobb法1和Cobb法2测量时当椎体出现轴向逆时针或顺时针旋转时差异具有统计学意义（P<0.05）。正常成人标准侧位摄片时3种测量方式测量胸腰椎相邻节段矢状曲度结果差异无显著性（P>0.05）。结论：DCRA法测量相邻节段矢状曲度准确性高，不同投照方式对其测量结果影响小；当椎体有轴向旋转时Cobb法1和Cobb法2测量矢状曲度将影响测量结果。

英文摘要:

  【Abstract】 Objective：To compare three methods on measuring sagittal plane curves in adjacent segments of thoracolumbar spine and to provide radiographic evidence for clinical practice.Method：42 times of thoracolumbar lateral views at varied postures were performed on 6 dried spine specimen and standard standing lateral views were obtained from 79 normal adults.The sagittal angle by distortion compensated roentgen analysis（DCRA method），the sagittal angle defined by two vertical lines perpendicular to the lines parallel to the superior endplate of above vertebra and the inferior endplate of below adjacent vertebral body（Cobb1 method），the sagittal angle defined by two vertical lines perpendicular to the lines parallel to the superior endplate of above vertebra and the superior endplate of below adjacent vertebral body（Cobb2 method）were used to measure sagittal plane curves.All results were reviewed statistically.Result：There was statistical significance among the three measurements for clockwise or counterclockwise posture for spine specimen （P<0.05），while no statistical significance among 6 specimens at different postural lateral view by using DCRA method（P>0.05）.There was statistical significance for clockwise or counterclockwise posture by using Cobb1 method and Cobb2 method （P<0.05）.There was no statistical significance among the three measurements of sagittal plane curves for adjacent segments for standard standing posture in normal adults （P>0.05）.Conclusion：DCRA method is accurate for measuring sagittal plane curves，different orientation has no impact on measurement，while vertebral rotation influences the measurement significantly by using Cobb1 and cobb2 methods.