中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (9): 1462-1468.doi: 10.12307/2022.999

• 骨与关节综述 bone and joint review • 上一篇    下一篇

体表形态度量在脊柱弯曲异常中的应用

胡希鉴，赵  斌，柴  火，刘海峰   

  1. 山西医科大学第二医院骨科，山西省太原市   030001
  • 收稿日期:2022-01-25 接受日期:2022-02-25 出版日期:2023-03-28 发布日期:2022-07-02
  • 通讯作者: 赵斌，博士，主任医师，山西医科大学第二医院骨科，山西省太原市 030001
  • 作者简介:胡希鉴，男，1994年生，山西省人，汉族，2018年山西医科大学毕业，山西医科大学在读硕士。
  • 基金资助:
    山西省卫生健康委课题(2020073)，负责人：赵斌

Application of trunk surface morphometry in vertebral column defects

Hu Xijian, Zhao Bin, Chai Huo, Liu Haifeng   

  1. Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • Received:2022-01-25 Accepted:2022-02-25 Online:2023-03-28 Published:2022-07-02
  • Contact: Zhao Bin, MD, Chief physician, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • About author:Hu Xijian, Master candidate, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • Supported by:
    a grant from Shanxi Provincial Health Commission, No. 2020073 (to ZB)

PDF

110

摘要：

文题释义：
脊柱弯曲异常：脊柱弯曲异常是常见的脊柱发育畸形，按病因可分为先天性、病理性、特发性和姿势性4种，在儿童少年中多见姿势性脊柱弯曲异常，由从事学习和活动时身体姿势经常不端正造成。
脊柱侧凸：俗称脊柱侧弯，它是一种脊柱的三维畸形，包括冠状位、矢状位和轴位上的序列异常。轻度的脊柱侧凸通常没有明显的不适，外观上也看不到明显的躯体畸形。较重的脊柱侧凸则会影响婴幼儿及青少年的生长发育，使身体变形，严重者可以影响心肺功能、甚至累及脊髓，造成瘫痪。轻度的脊柱侧凸可以观察，严重者需要手术治疗。脊柱侧凸是危害青少年和儿童的常见疾病，关键是要早发现、早治疗。

背景：随着光学技术的进步，现有体表形态度量方法的检测精度在不断提高，同时伴随软件技术的智能化，出现了各类新型检测技术和检测方法。
目的：文章回顾近年来体表形态度量应用在脊柱弯曲异常中的各类方法及研究进展，综述目前体表形态度量的局限之处及其发展趋势。
方法：第一作者应用计算机系统检索PubMed、Web of Science、中国知网和万方数据库中1980-2021年发表的文献，英文检索词为“vertebral column defects，spinal deformity，scoliosis，trunk surface，surface topography，TS，AIS，screening ”；中文检索词为“脊柱弯曲异常、脊柱畸形、脊柱侧凸、体表形态、表面形貌、筛查”。排除重复及质量较差的研究，共纳入72篇文献进行综述分析。
结果与结论：①作为无辐射的检测方法，体表形态度量技术安全性较放射检查高。但由于此类方法属于通过间接方式推断脊柱弯曲程度，其准确性仍有争议，目前仍无法取代放射检查在脊柱弯曲异常疾病诊治中的特殊地位。②目前体表形态度量分为3大类：第一类是以前屈试验、躯干旋转角测量为主的体格检查，长期应用于脊柱侧凸的筛查，为提高检查准确性需多种检查联合使用，检测效率较低；第二类是躯干美学临床评价、后躯干对称指数等为代表的二维图像测量方法，常用于对脊柱弯曲异常患者的定期监测；第三类是以莫尔图像、结构光、Formetric系统为代表的三维成像检测，近年来在突破了技术瓶颈后摆脱了其低效、苛刻的测量条件，测量精度高于二维图像测量，广泛应用于脊柱弯曲异常的临床工作中。③近年来依靠人工智能、大数据等新型信息技术开发的更高效的脊柱畸形筛查方法也时有报道，在改进现有的体表形态度量时，在满足采用直接方式测量、使用清晰准确的解剖标志、简化测量方案、明确指标正常阈值的情况下优化现有的体表形态度量或创建新型测量指标，才能够进一步提高体表形态度量的精度及有效性，便于扩大其使用范围。

https://orcid.org/0000-0001-5871-4805 (胡希鉴)；https://orcid.org/0000-0001-5360-6725 (赵斌)

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 脊柱弯曲异常, 体表形态, 脊柱侧凸, 筛查, X射线摄影, 光栅立体成像, 脊柱畸形

Abstract: BACKGROUND: With the progress of optical technology, the detection accuracy of existing trunk surface morphology measurement methods is constantly improving. At the same time, with the intelligence of software technology, various new detection technologies and methods have emerged. 
OBJECTIVE: To review various methods and research progress of the application of trunk surface morphometry in vertebral column defects in recent years, and summarize the limitations and development trend of trunk surface morphometry. 
METHODS: The first author searched the literature published from 1980 to 2021 on PubMed, Web of Science, CNKI, and Wanfang databases. The key words were “vertebral column defects, spinal deformation, scoliosis, trunk surface, surface topography, TS, AIS, screening”. After excluding repetitive and poor-quality studies, a total of 72 articles were included for analysis.
RESULTS AND CONCLUSION: (1) As a non-radiation detection method, the safety of trunk surface morphometry is higher than that of radiological examination, but its accuracy is still controversial because this method is an indirect way to infer the degree of spinal curvature. At present, it cannot replace the special status of radiological examination in the diagnosis and treatment of abnormal spinal curvature diseases. (2) At present, the measurement of trunk surface morphology is divided into three categories: one is the physical examination based on Adam’s test and trunk rotation angle measurement. It has been used in the screening of scoliosis for a long time. To improve the accuracy of the examination, a variety of examinations need to be used together, and the detection efficiency is low. The second is the two-dimensional image measurement method represented by the Trunk Aesthetic Clinical Evaluation and posterior trunk symmetry index, which is often used for the regular monitoring of patients with abnormal spinal curvature. The third is three-dimensional imaging detection represented by Moire image, structured light and Formetric system. In recent years, after breaking through the technical bottleneck, it has got rid of its inefficient and harsh measurement conditions. The measurement accuracy is higher than two-dimensional image measurement. It is widely used in the clinical work of spinal deformity. (3) In recent years, more efficient spinal deformity screening methods developed by relying on new information technologies such as artificial intelligence and big data have also been reported from time to time. When improving the existing trunk surface morphology measurement, optimizing the existing trunk surface morphology measurement or creating a new measurement index can further improve the accuracy and effectiveness of the trunk surface morphology measurement and expand its scope of use under the conditions of meeting the requirements of direct measurement, using clear and accurate anatomical landmarks, simplifying the measurement scheme and clarifying the normal threshold of the index. 

Key words: vertebral column defects, trunk surface, scoliosis, screening, radiography, rasterstereography, spinal deformity

中图分类号: