营养不良型和非营养不良型神经纤维瘤病性脊柱侧凸中异常椎弓根发生率的比较

Comparison of abnormal vertebral pedicles between dystrophic and nondystrophic scoliosis in neurofibromatosis type 1

中文关键词:  异常椎弓根  Ⅰ型神经纤维瘤病  脊柱侧凸  营养不良型  非营养不良型

英文关键词:Abnormal pedicles  Neurofibromatosis type 1  Scoliosis  Dystrophic  Nondystrophic

中文摘要:

  【摘要】 目的：观察Ⅰ型神经纤维瘤病性脊柱侧凸（neurofibromatosis type 1 scoliosis，NF1-S）中椎弓根异常的发生率，并比较其在营养不良型和非营养不良型NF1-S患者中的差异。方法：基于CT图像测量30例营养不良型和30例非营养不良型NF1-S患者的椎弓根，并根据椎弓根最宽平面的最窄距离将这些椎弓根分为5种类型：A型，松质骨通道＞4mm；B型，松质骨通道2～4mm；C型，松质骨通道＜2mm且皮质骨通道≥2mm；D型，皮质骨通道＜2mm且椎弓根存在；E型，椎弓根缺如。B、C、D和E型定义为异常。比较异常椎弓根在不同分型NF1-S患者中的发生率情况及其在侧凸弧范围内的分布情况。结果：NF1-S患者中异常椎弓根的发生率为67.5%（1376/2040），其中B型39.6%（807/2040），C型22.3%（455/2040），D型3.6%（74/2040），E型2.0%（40/2040）。侧凸弧范围内异常椎弓根发生率高达75.3%（975/1294），占全部异常椎弓根的70.9%（975/1376）。对于侧凸弧范围内，营养不良型NF1-S异常椎弓根发生率显著高于非营养不良型（83.3% vs. 66.7%，P＜0.05）。结论：NF1-S患者异常椎弓根主要集中于侧凸弧范围内，且营养不良型异常椎弓根发生率显著高于非营养不良型。

英文摘要:

  【Abstract】 Objectives: To explore the prevalence of abnormal vertebral pedicles in neurofibromatosis type 1 (NF1-S), and to compare the difference between dystrophic and nondystrophic scoliosis. Methods: Based on computed tomography images, vertebral pedicles from 30 patients with NF1-S with dystrophic scoliosis and 30 patients with NF1-S with nondystrophic scoliosis were carefully measured. Pedicle morphology was classified into five types: type A, cancellous channel >4mm; type B, cancellous channel from 2mm to 4mm; type C, cancellous channel <2mm with entirely cortical channel ≥2mm; type D, cortical channel <2mm; type E, absent pedicle. Type B, C, D and E were defined as abnormal. The incidence of anomalous pedicles in different NF1-S patients and their distribution in the area of lateral convex arc were compared. Results: The total prevalence of abnormal pedicles in patients with NF1-S was 67.5%(1376/2040), including type B 39.6%(807/2040), type C 22.3%(455/2040), type D 3.6%(74/2040) and type E 2.0%(40/2040). The prevalence of abnormal pedicles in the arc region was as high as 75.3%(975/1294), which accounted for 70.9% of total abnormal pedicles(975/1376). The prevalence of abnormal pedicles of dystrophic scoliosis was much higher than that of nondystrophic scoliosis(72.3% vs. 62.6%, P<0.05). Conclusions: Abnormal pedicles in patients with NF1-S mainly concentrate in the arc region. The prevalence of abnormal pedicles of dystrophic scoliosis is significantly higher than that of nondystrophic ones.