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目的描述原发性青少年脊柱侧弯患者胸椎肋横突孔形态学特点,并与正常人群胸椎肋横突孔形态比较,讨论通过此空间放置内固定物治疗生长期脊柱侧弯的可行性。方法回顾性分析我院2005年7月至2013年3月于骨科行门诊或术前CT扫描三维重建的原发性青少年脊柱侧弯(右胸弯)患者(侧弯组)以及2007年5月至2012年12月行CT检查但无脊柱畸形患者(对照组)的资料。脊柱侧弯组104例,男性42例,女性62例;平均年龄10岁。Lenke分型:Ⅰ型58例、Ⅲ型46例。主胸弯Cobb角平均为45.95°。对照组38例,男性15例,女性23例,平均年龄11岁。测量脊柱侧弯患者凸侧顶椎以及上下相邻两个椎体的肋横突孔横截面积,并与正常对照组相应节段面积进行对比,总结其变化规律。结果侧弯组肋横突孔横截面积为24.67~35.57 mm2;顶椎处横截面积小于邻近上下节段面积(P<0.05),横截面积和Cobb角呈负相关(r=-0.668,P<0.05)。对照组肋横突孔横截面积为28.26~32.57 mm2。侧弯组肋横突孔横截面积明显大于对照组的对应节段面积(P<0.05)。结论与正常人相比,中度原发性青少年脊柱侧弯患者侧弯凸侧胸椎肋横突孔横截面较大,可以通过此空间放置内固定器进行凸侧骨骺阻滞术。
Objective To describe the morphological features of transverse foramen of thoracic vertebra in patients with idiopathic juvenile scoliosis and to compare the morphology of transverse foramen of thoracic vertebrae in normal subjects. To discuss the feasibility of using this space to treat scoliosis during growth. Methods A retrospective analysis of our hospital from July 2005 to March 2013 in orthopedic out-patient or preoperative CT scan three-dimensional reconstruction of primary adolescent scoliosis (right chest bends) patients (side bending group) and in May 2007 Until December 2012 CT data but without spinal deformity (control group). Scoliosis group 104 cases, 42 males and 62 females; average age 10 years. Lenke classification: Ⅰ type 58 cases, Ⅲ type 46 cases. The main chest Cobb angle average 45.95 °. The control group of 38 patients, 15 males and 23 females, mean age 11 years. The transverse cross-sectional area of the transverse foramen of the convex vertebra and the adjacent two vertebrae in the scoliosis patients were measured and compared with the corresponding segment area of the normal control group to summarize the changes. Results The transverse cross-sectional area of lateral foramina was 24.67-35.57 mm2. The cross-sectional area of the vertebral vertebra was smaller than that of the adjacent upper and lower segments (P <0.05), and the cross-sectional area was negatively correlated with Cobb angle (r = -0.668, P <0.05). The transverse cross-sectional area of ribs in the control group was 28.26 ~ 32.57 mm2. The transverse cross-sectional area of the lateral foramina was significantly larger than that of the control group (P <0.05). Conclusion Compared with normal people, the transverse cross-section of the transverse foramen of lateral thoracic vertebrae in patients with moderate primary adolescent scoliosis is larger, and the epiphysis of the convex side can be blocked by placing the internal fixation device in this space.