Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis
Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis
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DOI：
10.1097/01.brs.0000142224.46796.a7
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发表时间：
2004-10-15
期刊：
影响因子：
3
通讯作者：
Newton, PO
中科院分区：
文献类型：
--
作者：
Faro, FD;Marks, MC;Newton, PO
设计对50例青少年特发性脊柱侧凸（AIS）患者的侧位X线片进行回顾性检查，以评估患者在两种不同站立位的矢状面。评价与两个站立位X线摄影位置相关的脊柱矢状面的节段性和整体性变化，并确定一个位置是否代表更功能性的站立位，以进行准确的矢状面平衡评价。放松站立时脊柱矢状面平衡的研究表明，由骶骨后上级角C7铅垂线的水平位移确定的矢状面垂直轴（SVA）为中性或稍正。然而，站立时手臂向前弯曲以允许脊柱的放射学可视化导致SVA的负偏移。从AIS患者两种不同站立姿势的站立位侧位X线片中获得测量值：手臂向前弯曲至45度，肘部完全伸展，肘部完全弯曲，拳头放在锁骨上。采用相关性分析和重复测量方差分析对各参数进行统计学分析，显著性设为0.005。研究队列包括25名仅接受非手术治疗（无进展）的患者和25名因脊柱侧凸接受手术干预的患者。在所有患者中，当手臂处于前屈位时，SVA的负性更大（C7相对于骶骨更后移），而拳头置于锁骨位时，SVA的负性更大（-4.2+/-2.5 cm vs. -1.3+/-2.4 cm，P
Design. A retrospective examination of lateral spine radiographs of 50 patients with adolescent idiopathic scoliosis (AIS) was performed to evaluate the sagittal profile of patients in two different standing positions.Objectives. To evaluate segmental and global changes in the sagittal profile of the spine associated with two standing radiographic positions and determine if one position represents a more functional stance for accurate sagittal balance evaluation.Summary of Background Data. Studies of spinal sagittal balance during relaxed standing have indicated that the sagittal vertical axis (SVA), as determine by the horizontal displacement of a C7 plumb line from the posterior superior corner of the sacrum, is neutral or slightly positive. However, standing with the arms forward flexed to allow radiographic visualization of the spine results in a negative shift in SVA.Methods. Measurements were obtained from standing lateral radiographs in patients with AIS in two different standing positions: arms forward flexed to 45 with elbows fully extended versus elbows fully flexed with fists resting on clavicles. Sagittal plane parameters were analyzed using correlation analyses and repeated-measures analyses of variance with significance set at 0.005.Results. The study cohort included 25 patients who had undergone solely nonoperative treatment (without progression) and 25 patients who had undergone operative intervention for their scoliosis. In all patients, SVA was more negative (C7 shifted more posterior with respect to the sacrum) when the arms were in the forward flexed position compared to the fists on clavicles position (-4.2+/-2.5 cm vs. -1.3+/-2.4 cm, P