Sequential MRI reveals vertebral body wedging significantly contributes to coronal plane deformity progression in adolescent idiopathic scoliosis during growth
Sequential MRI reveals vertebral body wedging significantly contributes to coronal plane deformity progression in adolescent idiopathic scoliosis during growth
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DOI：
10.1007/s43390-020-00138-w
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发表时间：
2020-10-01
期刊：
影响因子：
1.6
通讯作者：
Little, J. Paige
中科院分区：
文献类型：
--
作者：
Labrom, Fraser R.;Izatt, Maree T.;Little, J. Paige
研究设计横断面研究目的：使用一系列连续的磁共振成像（MRI），为具有主要胸曲类型的青少年特发性脊柱侧凸（AIS）患者的椎体（VB）和椎间盘（IVD）冠状面畸形提供全面的、多阶段的研究。背景数据总结尽管在脊柱节段水平对AIS畸形进行了大量研究，对于造成脊柱侧凸脊柱侧弯的主要因素，几乎没有共识。此外，脊柱侧凸畸形通常被描述为沿着一个连续的进展，很少有研究描述AIS患者的节段性畸形变化，这些患者的畸形随着时间的推移而临床进展。对每例患者采集三次连续MRI。重新格式化数据集，以生成胸椎（T4-L1）的真实冠状面图像。整体曲线形态，冠状面IVD和VB节段畸形和growth. ResultsRight侧不对称是更大的IVD（18.5 - 23.9%）相比，VB（8.39.2%）（P50%），其冠状面曲率是由于VB楔入测量时，在所有三个扫描。无论进展状态、扫描次数或区域如何，VB楔形角的总和均大于IVD楔形角的总和（均P 0.05）。结论VB楔形对AIS患者原发胸部亚型中观察到的外侧畸形的贡献大于IVD楔形。虽然IVD表现出最大的不对称畸形，但与VBs相比，其相对较小的高度导致了较小的侧弯角度比例变化。
Study designCross-sectional study.ObjectivesTo provide a comprehensive, multi-stage investigation of vertebral body (VB) and intervertebral disc (IVD) coronal plane deformities for adolescent idiopathic scoliosis (AIS) patients with a main thoracic curve type, using a series of sequential magnetic resonance images (MRIs).Summary of background dataDespite numerous investigations of AIS deformity at the spinal segmental level, there is little consensus as to the major contributor to the lateral curvature of a scoliotic spine. Moreover, scoliotic deformity is often described along a continuum of progression, with few studies having characterised the change in segmental deformity for AIS patients whose deformity progresses clinically over time.Methods30 female AIS patients with primary thoracic curves were included between 2012 and 2016. Three sequential MRIs were captured for each patient. Datasets were reformatted to produce true coronal plane images of the thoracic spine (T4-L1). Overall curve morphology, coronal plane IVD and VB segmental deformity and rates of growth were analysed.ResultsRight-side asymmetry was greater in IVDs (18.523.9%) when compared to VBs (8.39.2%) (P50%) of their coronal curvature was attributed to VB wedging when measured across all three scans. Regardless of progression status, scan number, or region, the sum of the VB wedging angle was greater than the sum of the IVD wedging angle (all P 0.05).ConclusionsVB wedging contributed more to the lateral deformity observed in primary thoracic subtypes of AIS patients than IVD wedging. While IVDs demonstrated the greatest asymmetric deformity, their relatively smaller height resulted in a smaller proportional change in lateral curve angle compared to the VBs.Level of evidenceIV.