Morphometric analysis of thoracic and lumbar vertebrae in idiopathic scoliosis
Morphometric analysis of thoracic and lumbar vertebrae in idiopathic scoliosis
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DOI：
10.1097/00007632-200005150-00008
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发表时间：
2000-05-15
期刊：
影响因子：
3
通讯作者：
Halm, HFH
中科院分区：
文献类型：
--
作者：
Liljenqvist, UR;Link, TM;Halm, HFH
研究设计。 29例特发性脊柱侧凸患者337个椎弓根形态测量的前瞻性研究。目的。通过计算机断层扫描分析椎弓根螺钉器械治疗特发性脊柱侧凸的椎体形态。背景数据摘要。尽管对正常脊柱的椎骨形态测量存在一些研究，但对侧凸椎骨的形态测量方法知之甚少。通过计算机断层扫描分析 29 例手术治疗的特发性右胸椎侧凸患者的 T5 和 L4 之间的椎弓根形态测量，测量包括弦长、骨内膜横向椎弓根宽度、横向椎弓根角度和椎弓根长度。结果。胸椎顶端区域凹处的骨内膜横向椎弓根宽度显着较小（P < 0.05），中胸椎（T5-T9）测量在2.5至4.2 mm之间，下胸椎（T10-T12）测量在4.2至5.9 mm之间。腰椎宽度在4.8~9.5 mm之间变化，凹凸侧差异无显着性（P > 0.05）。 T5 处弦长最短，为 37 mm，L3 处弦长逐渐增加至 50 mm，其中男性患者和胸椎顶端凹处的弦长明显更大（P < 0.05）。椎弓根长度变化最小，范围在 20 至 22 毫米之间，并且在整个胸椎和腰椎中相对一致。下胸椎椎弓根横向角度为6°，上胸椎和下腰椎椎弓根横向角度为12°。结论。侧凸椎骨的形态与正常脊柱的椎骨有很大不同，侧凸椎骨表现出不对称的椎内畸形。由于骨内膜椎弓根宽度较小，胸椎曲线顶端区域凹处的椎弓根螺钉器械显得至关重要。
Study Design. Prospective study on the morphometry of 337 pedicles in 29 patients with idiopathic scoliosis.Objectives. To analyze by means of computed tomographic scans the vertebral morphometry in idiopathic scoliosis treated by pedicle screw instrumentation.Summary of Background Data. Although several studies exist on the vertebrae's morphometry in normal spines, little is known concerning the morphometry of scoliotic vertebrae,Methods. The pedicles' morphometry between T5 and L4 was analyzed by computed tomographic scans in 29 surgically treated patients with idiopathic right thoracic scoliosis, Measurements included chord length, endosteal transverse pedicle width, transverse pedicle angle, and pedicle length.Results. The endosteal transverse pedicle width was significantly smaller (P < 0.05) on the concavity in the apical region of the thoracic spine and measured between 2.5 and 4.2 mm in the middle thoracic spine (T5-T9) and between 4.2 and 5.9 mm in the lower thoracic spine (T10-T12). In the lumbar spine, the width varied between 4.8 and 9.5 mm without significant differences between the concave and convex sides (P > 0.05). The chord length was shortest at T5, measuring 37 mm and increased gradually to 50 mm at L3 with significantly larger dimensions in male patients and on the concavity of the apical region in the thoracic spine (P < 0.05). The pedicle length varied minimally, with a range of between 20 and 22 mm, and was relatively consistent throughout the thoracic and lumbar spine. The transverse pedicle angle varied between 6 degrees in the lower thoracic spine and 12 degrees in the upper thoracic and lower lumbar spine.Conclusion. The morphometry in scoliotic vertebrae is substantially different from that of vertebrae in normal spines, with an asymmetrical intravertebral deformity shown in scoliotic vertebrae. Pedicle screw instrumentation on the concavity in the apical region of thoracic curves appears critical because of the small endosteal pedicle width.