Uncoupled neuro-osseous growth in adolescent idiopathic scoliosis? A preliminary study of 90 adolescents with whole-spine three-dimensional magnetic resonance imaging
Uncoupled neuro-osseous growth in adolescent idiopathic scoliosis? A preliminary study of 90 adolescents with whole-spine three-dimensional magnetic resonance imaging
复制标题
青少年特发性脊柱侧弯的神经骨生长不耦合？
DOI：
10.1007/s00586-010-1471-1
复制
发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Qiu, Gui-Xing
中科院分区：
文献类型：
--
作者：
Lao, Li-Feng;Shen, Jian-Xiong;Qiu, Gui-Xing
以往文献显示AIS的脊髓横断面形态异常，提示存在神经系统和骨骼系统的不成比例生长。研究MRI多平面重建对全脊柱的测量不准确及其与Cobb角的相关性。在这项研究中，对90名青少年（49名AIS伴胸椎/胸腰椎弯曲，41名年龄匹配的健康对照）进行了全脊柱MRI三维重建。在AIS患者的心尖水平上测量脊髓前后径（AP）和横径（TS）的比值，以及脊髓外侧间隙（LCS）的凹和凸。测量小脑扁桃体水平与基底-视点线、脊髓圆锥位置、脊髓长度、脊柱长度、脊髓/脊柱长度比值的关系。所有相同的参数也测量了健康对照组在匹配的椎体水平，并与Cobb角的相关性。小脑扁桃体水平低卧位、脊髓圆锥抬高位的AIS患者AP、TS、AP/TS、LCS均较正常对照组增高（P < 0.01）。AP、AP/TS、LCS比值与Cobb角呈显著正相关（P < 0.05）。脊髓长度和脊柱长度在AIS组和对照组之间无显著差异。而AIS组脊髓/脊柱长度比明显较小（P < 0.01）。脊髓长度、脊柱长度、脊髓/脊柱长度比与年龄、Cobb角无关（P > 0.05）。这些数据表明，存在非偶联的神经-骨生长沿着脊髓的纵轴与相关的形态学变化的横截面配置和相对位置的脊髓。某些改变与Cobb角有显著相关性，可能提示AIS的发病机制。
Previous literatures revealed abnormal cross-sectional morphology of spinal cord in AIS, suggesting the presence of disproportional growth between the neural and skeletal system. No accurate measurement of whole spine by MRI multiplanar reconstruction and their correlation with Cobb angle were studied. In this study, MRI three-dimensional reconstruction of the whole spine was performed in 90 adolescents (49 AIS with thoracic/thoracolumbar curve, and 41 age-matched healthy controls). Measurements of the ratio of anteroposterior (AP) and transverse (TS) diameter of the cord, the concave and convex lateral cord space (LCS) were obtained at the apical level in AIS patients. Cerebellar tonsillar level related to the basion-opsithion line, location of conus medullaris, cord length, vertebral column length, cord/vertebral column length ratio were obtained. All of the same parameters were also measured in healthy controls at matched vertebral levels and their correlations with Cobb angle were made. We notice that AP, TS, AP/TS and LCS ratio were increased in AIS subjects with low-lying position of cerebellar tonsillar level and elevating position of conus medullary when compared with healthy controls (P < 0.01). AP, AP/TS and LCS ratio were correlated significantly with Cobb angle (P < 0.05). Cord length and vertebral column length were not significantly different between AIS and control group. However, cord/vertebral column length ratio was significantly smaller in AIS group (P < 0.01). Cord length, vertebral column length and cord/vertebral column length ratio were not related with age or Cobb angle (P > 0.05). These data suggest the presence of uncoupled neuro-osseous growth along the longitudinal axis of spinal cord with associated morphologic changes of cross-sectional configuration and relative position of the cord. Some changes are significantly relevant with Cobb angle, which may indicate pathogenesis of AIS.