青少年特发性脊柱侧凸患者和正常人骶骨矢状位参数的差异

Differences in sacral sagittal parameters between adolescent idiopathic scoliosis patients and normal individuals

中文关键词:  青少年特发性脊柱侧凸  影像学研究  骶骨矢状位参数  性别差异

英文关键词:Adolescent idiopathic scoliosis  Imaging study  Sacral sagittal parameters  Gender differences

中文摘要:

  【摘要】 目的：探究青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者与正常人骶骨矢状位参数的差异以及AIS患者骶骨矢状位参数的性别差异。方法：回顾性分析141例10～19岁AIS患者和388名正常人的自然站立位脊柱全长正侧位X线片影像学资料，测量其脊柱-骨盆参数：胸椎后凸角（thoracic kyphosis，TK）、胸腰椎后凸角（thoracolumbar kyphosis，TLK）、腰椎前凸角（lumbar lordosis，LL）、骶骨倾斜角（sacral slope，SS）、骨盆倾斜角（pelvic tilt，PT）、骨盆入射角（pelvic incidence，PI）；同时测量其骶骨矢状位参数：S1上终板与S1-2倾斜线的夹角（ST12）、S1倾斜线与S2倾斜线的夹角（S1T-S2T）、S1-2倾斜线与S5Co1倾斜线的夹角（骶骨后凸，sacral kyphosis，SK）、S1上终板与S2Co1倾斜线的夹角（S2聚合角，S2 convergence angle，S2CA）、S1上终板与S1Co1倾斜线的夹角（骶骨聚合角，sacral convergence angle，SCA）。对相关参数进行统计学描述、差异性检验。结果：AIS患者TK、TLK、S1T-S2T、ST12、PI、SS以及LL和正常人之间的差异有统计学意义，TK、TLK、S1T-S2T以及ST12（绝对值）比正常人小，PI、SS以及LL（绝对值）比正常人大；PT、SK、SCA、S2CA在二者之间的差异无统计学意义。Lenke1型AIS患者中，TK、TLK、SS、PT、S1T-S2T和正常人之间的差异有统计学意义，其中TK、TLK、PT、S1T-S2T比正常人小，SS比正常人大；Lenke5型AIS患者中，TK、SS、PI、S1T-S2T和正常人之间的差异有统计学意义，其中TK和S1T-S2T比正常人小，SS、PI比正常人大。TLK、ST12、SCA、S2CA在男、女AIS患者之间的差异有统计学意义，女性AIS患者拥有更大的ST12、SCA、S2CA（绝对值）；男性患者ST12、SCA、S2CA与正常人的差异有统计学意义，而在女性患者中上述参数与正常人的差异均无统计学意义（P＜0.05）。结论：AIS患者与正常人骶骨矢状位参数存在差异；AIS患者骶骨矢状位参数存在性别差异，男性患者骶骨在矢状位参数上的变化更加显著。

英文摘要:

  【Abstract】 Objectives: To investigate the differences in sacral sagittal parameters between patients with adolescent idiopathic scoliosis(AIS) and normal individuals, as well as between different genders of AIS patients. Methods: A retrospective analysis was conducted on the full-length spinal X-ray images of 141 AIS patients aged 10 to 19 years and 388 normal individuals. The following spinal-pelvic sagittal parameters were measured: thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), lumbar lordosis(LL), sacral slope(SS), pelvic tilt(PT), and pelvic incidence(PI). Sacral sagittal parameters were measured, including the angle between S1 upper-endplate and S1-2 tilt(ST12), angle between S1 tilt and S2 tilt(S1T-S2T), angle between S1-2 tilt and S5Co1 tilt(sacral kyphosis, SK), angle between S1 upper-endplate and S1Co1 tilt(sacral convergence angle, SCA), and angle between S1 upper-endplate and S2Co1 tilt(S2 convergence angle, S2CA). Descriptive statistics and difference tests were conducted on the relevant parameters. Results: Overall, AIS patients had smaller TK, TLK, S1T-S2T, and ST12(absolute value), and larger PI, SS, and LL(absolute value) compared to normal individuals. There was no significant difference between the two groups in terms of PT, SK, SCA, and S2CA. In Lenke 1 AIS patients, there were significant differences in TK, TLK, SS, PT, and S1T-S2T compared to normal individuals, with smaller TK, TLK, PT, and S1T-S2T, and larger SS. In Lenke 5 AIS patients, there were significant differences in TK, SS, PI, and S1T-S2T compared to normal individuals, with smaller TK and S1T-S2T, and larger SS and PI. There were significant differences in TLK, ST12, SCA, and S2CA between female and male AIS patients, with female AIS patients having larger ST12, SCA, and S2CA(absolute value). In male patients, there were significant differences in ST12, SCA, and S2CA compared to normal individuals, while in female patients, there were no significant differences in the above parameters compared to normal individuals(P<0.05). Conclusions: AIS patients exhibit differences in sacral sagittal parameters compared to normal individuals, which vary by gender, with male patients demonstrating more pronounced changes.