The effect of scoliotic deformity on spine kinematics in adolescents.
The effect of scoliotic deformity on spine kinematics in adolescents.
复制标题
脊柱侧面畸形对青少年脊柱运动学的影响。
DOI：
10.1186/s13013-016-0103-x
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发表时间：
2016
影响因子：
--
通讯作者：
Friis E
中科院分区：
文献类型：
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作者：
Galvis S;Burton D;Barnds B;Anderson J;Schwend R;Price N;Wilson S;Friis E
虽然青少年特发性脊柱侧凸（AIS）在脊柱形态上产生明显的变形，但对脊柱功能（即活动能力）的影响尚不清楚。更好地了解脊柱侧凸的脊柱活动可以提供更好的治疗靶点和诊断。本研究的目的是表征AIS引起的脊柱活动差异。假设AIS组与典型青少年（TA）组相比会表现出较低的活动能力。11名青少年右胸椎AIS，尖端T6-T10和11名年龄和性别匹配的ta在矢状面和冠状面弯曲任务中移动到最大弯曲位置。Trakstar （Ascension Technologies Burlington， VT）用于收集位置数据。这项研究得到了当地审查委员会的批准。利用MATLAB （MathWorks, Natick， MA）计算T1-T3的上胸椎（UT）、T3-T6的中胸椎（MT）、T6-T10的下胸椎（LT）、T10-L1的胸腰椎（TL）、L1-L3的上腰椎（UL）和T1-L1的胸椎的归一化节段角度，方法是用最大弯曲位置减去站立位置，然后除以每个节段的运动单元数。采用Mann Whitney检验（α = 0.05）测定迁移率差异。研究结果表明，AIS组在脊柱根尖周围区域的活动度相对增加。AIS组增加了1.2°胸中期地区在弯曲(p = 0.01),增加了1.0°中期胸地区(p = 0.01),胸腰椎地区1.5°(p = 0.02),和0.7°胸地区在左前侧弯曲(p = 0.04),增加了6.0°上腰部在右前侧弯曲(p = 0.02),和增加了2.2°上腰部在左横向弯曲(p < 0.01)。AIS患者的矢状面或冠状面活动能力没有降低。相反，AIS组通常具有更大的活动性，特别是在顶端上方和下方的节段。这表明脊柱侧凸是灵活的，可能在顶点附近进行补偿。
While adolescent idiopathic scoliosis (AIS) produces well characterized deformation in spinal form, the effect on spinal function, namely mobility, is not well known. Better understanding of scoliotic spinal mobility could yield better treatment targets and diagnoses. The purpose of this study was to characterize the spinal mobility differences due to AIS. It was hypothesized that the AIS group would exhibit reduced mobility compared to the typical adolescent (TA) group. Eleven adolescents with right thoracic AIS, apices T6-T10, and eleven age- and gender-matched TAs moved to their maximum bent position in sagittal and coronal plane bending tasks. A Trakstar (Ascension Technologies Burlington, VT) was used to collect position data. The study was approved by the local IRB. Using MATLAB (MathWorks, Natick, MA) normalized segmental angles were calculated for upper thoracic (UT) from T1-T3, mid thoracic (MT) from T3-T6, lower thoracic (LT) from T6-T10, thoracolumbar (TL) from T10-L1, upper lumbar (UL) from L1-L3, and thoracic from T1-L1 by subtracting the standing position from the maximum bent position and dividing by number of motion units in each segment. Mann Whitney tests (α = 0.05) were used to determine mobility differences. The findings indicated that the AIS group had comparatively increased mobility in the periapical regions of the spine. The AIS group had an increase of 1.2° in the mid thoracic region (p = 0.01) during flexion, an increase of 1.0° in the mid thoracic region (p = 0.01), 1.5° in the thoracolumbar region (p = 0.02), and 0.7° in thoracic region (p = 0.04) during left anterior-lateral flexion, an increase of 6.0° in the upper lumbar region (p = 0.02) during right anterior-lateral flexion, and an increase of 2.2° in the upper lumbar region during left lateral bending (p < 0.01). Participants with AIS did not have reduced mobility in sagittal or coronal motion. Contrarily, the AIS group often had a greater mobility, especially in segments directly above and below the apex. This indicates the scoliotic spine is flexible and may compensate near the apex.