中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (6): 852-856.doi: 10.12307/2023.731

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

青少年特发性脊柱侧凸患者冠状面压力变异与冠状面失衡的关系

吴茂东1，苏清伦1，黄一鸣1，2，沈龙莹1，卢  钰1，赵  秦1   

  1. 1南京医科大学康达学院附属连云港市第一人民医院，江苏省连云港市   222000；2锦州医科大学，辽宁省锦州市   121001
  • 收稿日期:2022-10-17 接受日期:2022-11-23 出版日期:2024-02-28 发布日期:2023-07-11
  • 通讯作者: 赵秦，硕士，副主任中医师，研究生导师，南京医科大学康达学院附属连云港市第一人民医院，江苏省连云港市 222000
  • 作者简介:吴茂东，男，1992年生，江苏省连云港市人，2015年南京医科大学毕业，主管治疗师，主要从事脊柱侧凸康复评估与治疗研究。
  • 基金资助:
    连云港市卫生科技项目(202003)，项目负责人：赵秦；连云港市第一人民医院临床研究基金项目(LC29)，项目负责人：赵秦

Correlation between coronal pressure variation and coronal imbalance in adolescent idiopathic scoliosis patients

Wu Maodong1, Su Qinglun1, Huang Yiming1, 2, Shen Longying1, Lu Yu1, Zhao Qin1   

  1. 1Lianyungang First People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang 222000, Jiangsu Province, China; 2Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
  • Received:2022-10-17 Accepted:2022-11-23 Online:2024-02-28 Published:2023-07-11
  • Contact: Zhao Qin, Master, Associate chief TCM physician, Master’s supervisor, Lianyungang First People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang 222000, Jiangsu Province, China
  • About author:Wu Maodong, Therapist-in-charge, Lianyungang First People’s Hospital Affiliated to Kangda College of Nanjing Medical University, Lianyungang 222000, Jiangsu Province, China
  • Supported by:
    Lianyungang Science Technology and Health Project, No. 202003 (to ZQ); Clinical Research Fund Project of Lianyungang First People’s Hospital, No. LC29 (to ZQ)

PDF

20

摘要：


文题释义：

压力变异：人体仰卧位压力评估时通过折叠平板可把受试者上半身和下半身摆位成180°夹角(即平卧位)或120°夹角(即为折叠位)，折叠位压力与平卧位压力的差值即为压力变异，是人体背侧软组织被牵拉后产生的反作用力。
冠状面失衡：指躯体在冠状面的偏移程度，常用评价方法为X射线片测量的cobb角、冠状面平衡和顶椎偏距等，是临床上评价脊柱侧凸的常用指标。


背景：青少年特发性脊柱侧凸患者人体水平面压力分布可用于冠状面失衡评价，当前尚无冠状面压力分布特点及与冠状面失衡相关性的报道。

目的：探究青少年特发性脊柱侧凸患者冠状面压力变异与脊柱冠状面失衡的相关性。
方法：选择2021年3月至2022年6月在连云港市第一人民医院就诊的符合纳入排除标准的青少年特发性脊柱侧凸患者39例为青少年特发性脊柱侧凸组，同时门诊招募匹配健康志愿者30例为对照组。使用TBED Postural Couch评估系统测量两组人群平卧位压力、折叠位压力、变异系数、整体和局部压力变异；青少年特发性脊柱侧凸组进行脊柱全长X射线摄片，测量cobb角、冠状面平衡、顶椎偏距和Nash-Moe旋转度，分析冠状面压力变异特点及与冠状面失衡的相关性。

结果与结论：①与对照组比，青少年特发性脊柱侧凸组平卧位压力、折叠位压力差异无显著性意义(P > 0.05)，整体压力变异和变异系数显著升高(均P < 0.05)；②青少年特发性脊柱侧凸组躯干部凸、凹侧与对照组躯干部左、右侧压力变异组间存在差异(P < 0.05)，且青少年特发性脊柱侧凸组躯干部凸侧压力变异>凹侧压力变异>对照组躯干部左、右侧压力变异(均P < 0.05)；③青少年特发性脊柱侧凸患者躯干部凸侧压力变异与冠状面平衡强度正相关(r=0.692，P < 0.05)，与cobb角和顶椎偏距中度正相关(r=0.499，0.595，均P < 0.05)，与Nash-Moe分级弱相关(r=0.377，P < 0.05)；躯干部凹侧压力变异与冠状面平衡中度正相关(r=0.410, P < 0.05)，余为弱相关或不相关(P > 0.05)；④结果提示，躯干部压力变异或许可用于轻中度脊柱侧凸患者的辅助评估工具。

https://orcid.org/0000-0002-3935-8857 (吴茂东) 

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: 青少年特发性脊柱侧凸, 压力变异, 冠状面失衡, 相关分析, cobb角, 冠状面平衡, 顶椎偏距

Abstract: BACKGROUND: The distribution of horizontal pressure in adolescent idiopathic scoliosis can be used to evaluate the coronal imbalance. Currently, there are no reports on the characteristics of coronal pressure distribution and its correlation with coronal imbalance.  
OBJECTIVE: To explore the correlation between coronal pressure variation and coronal imbalance in adolescent idiopathic scoliosis patients.
METHODS: A total of 39 adolescent idiopathic scoliosis patients who met the inclusion and exclusion criteria in Lianyungang First People’s Hospital from March 2021 to June 2022 were selected as the adolescent idiopathic scoliosis group, and 30 matched healthy volunteers were recruited from the outpatient department as the control group. The horizontal position pressure, folding position pressure, coefficient of variation, and global and trunk pressure variation were measured by the TBED Postural Couch evaluation system. In the adolescent idiopathic scoliosis group, full-length spine radiographs were taken to measure Cobb angle, coronal balance, apical vertebral deviation and Nash-Moe rotation. The characteristics of coronal pressure variation and its correlation with coronal imbalance were analyzed.  
RESULTS AND CONCLUSION: (1) Compared with the control group, there was no statistically significant difference in the horizontal position pressure and folding position pressure in the adolescent idiopathic scoliosis group (P > 0.05), but the global pressure variation and coefficient of variation were significantly increased (all P < 0.05). (2) There were differences in both sides of the trunk of the adolescent idiopathic scoliosis group and the control group (P < 0.05), and the convex side pressure variation in the adolescent idiopathic scoliosis group was higher than the concave side pressure variation in the left and right side pressure variation in the control group (all P < 0.05). (3) The variation of the convex side pressure of the trunk in adolescent idiopathic scoliosis patients was positively correlated with coronal balance intensity (r=0.692, P < 0.05), moderately positively correlated with Cobb angle and apical vertebral deviation (r=0.499, 0.595, all P < 0.05), and weakly correlated with Nash-Moe grade (r=0.377, P < 0.05). The variation of the concave side pressure of the trunk was moderately positively correlated with coronal balance (r=0.410, P < 0.05), and the rest was weakly correlated or not correlated (P > 0.05). (4) These findings indicate that pressure variation may be used as an adjoint assessment tool in patients with mild to moderate scoliosis.

Key words: adolescent idiopathic scoliosis, pressure variation, coronal imbalance, correlation analysis, Cobb angle, coronal balance, apical vertebral deviation

中图分类号: