Abstract：
BACKGROUND: Bracing is the most common conservative treatment for preventing the progression of adolescent idiopathic scoliosis (AIS) in patients with a curve of 25°-40°. X-ray examinations are traditionally performed in the standing position. However, school-age teenagers may take more time to sit. Thus far, little is known about three-dimensional (3D) correction in the sitting position. Hence, this study aimed to determine the effects of standing and sitting positions on 3D parameters during brace correction.
METHODS: We evaluated a single-center cohort of patients receiving conservative treatment for thoracic curvature (32 patients with AIS with a Lenke I curve). The 3D parameters of their standing and sitting positions were analyzed using the EOS imaging system during their first visit and after bracing.
RESULTS: At the patients\' first visit, sagittal plane parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), and sacral slope decreased when transitioning from the standing position to the sitting position (standing 29° ± 6°, 42° ± 8°, and 42° ± 8° vs. sitting 22° ± 5°, 27° ± 6°, and 24° ± 4°; p < 0.001), whereas pelvic tilt (PT) increased and sagittal vertical axis shifted forward (standing 9° ± 6° and 1.6 ± 2.7 cm vs. sitting 24° ± 4° and 3.8 ± 2.3 cm; p < 0.001). After bracing, TK and LL decreased slightly (from 29° ± 6° and 42° ± 8° to 23° ± 3° and 38° ± 6°; p < 0.001), whereas the thoracolumbar junction (TLJ) value increased (from 3° ± 3° to 11° ± 3°; p < 0.001). When transitioning to the sitting position, similar characteristics were observed during the first visit, except for a subtle increase in the TLJ and PT values (standing 11° ± 3° and 9° ± 4° vs. sitting 14° ± 3° and 28° ± 4°; p < 0.001). Moreover, the coronal and axial parameters at different positions measured at the same time showed no significant change.
CONCLUSIONS: In brace-wearing patients with thoracic scoliosis, compensatory sagittal plane straightening may be observed with a slight increase in thoracolumbar kyphosis, particularly when transitioning from the standing position to the sitting position, due to posterior rotation of the pelvis. Our results highlight that sagittal alignment in AIS with brace treatment is not completely analyzed with only standing X-Ray.
BACKGROUND: The study protocol was registered with the Chinese Clinical Trial Registry (ChiCTR1800018310).
METHODS: We evaluated a single-center cohort of patients receiving conservative treatment for thoracic curvature (32 patients with AIS with a Lenke I curve). The 3D parameters of their standing and sitting positions were analyzed using the EOS imaging system during their first visit and after bracing.
RESULTS: At the patients\' first visit, sagittal plane parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), and sacral slope decreased when transitioning from the standing position to the sitting position (standing 29° ± 6°, 42° ± 8°, and 42° ± 8° vs. sitting 22° ± 5°, 27° ± 6°, and 24° ± 4°; p < 0.001), whereas pelvic tilt (PT) increased and sagittal vertical axis shifted forward (standing 9° ± 6° and 1.6 ± 2.7 cm vs. sitting 24° ± 4° and 3.8 ± 2.3 cm; p < 0.001). After bracing, TK and LL decreased slightly (from 29° ± 6° and 42° ± 8° to 23° ± 3° and 38° ± 6°; p < 0.001), whereas the thoracolumbar junction (TLJ) value increased (from 3° ± 3° to 11° ± 3°; p < 0.001). When transitioning to the sitting position, similar characteristics were observed during the first visit, except for a subtle increase in the TLJ and PT values (standing 11° ± 3° and 9° ± 4° vs. sitting 14° ± 3° and 28° ± 4°; p < 0.001). Moreover, the coronal and axial parameters at different positions measured at the same time showed no significant change.
CONCLUSIONS: In brace-wearing patients with thoracic scoliosis, compensatory sagittal plane straightening may be observed with a slight increase in thoracolumbar kyphosis, particularly when transitioning from the standing position to the sitting position, due to posterior rotation of the pelvis. Our results highlight that sagittal alignment in AIS with brace treatment is not completely analyzed with only standing X-Ray.
BACKGROUND: The study protocol was registered with the Chinese Clinical Trial Registry (ChiCTR1800018310).
摘要：
背景：在25°-40°的曲线患者中，支撑是预防青少年特发性脊柱侧凸（AIS）进展的最常见的保守治疗方法。X射线检查传统上是在站立位置进行的。然而,学龄儿童可能需要更多的时间来坐。到目前为止,关于坐姿的三维（3D）校正知之甚少。因此，这项研究旨在确定站立和坐姿对支撑矫正过程中3D参数的影响。
方法：我们评估了接受保守治疗的胸廓弯曲患者的单中心队列（32例具有LenkeI曲线的AIS患者）。在他们第一次就诊和支撑后，使用EOS成像系统分析了他们站立和坐姿的3D参数。
结果：患者首次就诊时，矢状面参数，如胸椎后凸（TK），腰椎前凸(LL),从站立姿势过渡到坐姿时，骶骨坡度减小(站立29°±6°，42°±8°,和42°±8°vs.坐22°±5°，27°±6°,和24°±4°；p<0.001)，而骨盆倾斜（PT）增加，矢状垂直轴向前移动（站立9°±6°和1.6±2.7cmvs.坐24°±4°和3.8±2.3厘米；p<0.001）。支撑之后,TK和LL略有下降（从29°±6°和42°±8°下降到23°±3°和38°±6°；p<0.001），而胸腰椎交界处（TLJ）值增加（从3°±3°增加到11°±3°；p<0.001）。当过渡到坐姿时，在第一次访问中观察到类似的特征，除了TLJ和PT值的细微增加（站立11°±3°和9°±4°与坐14°±3°和28°±4°；p<0.001)。此外，同时测量的不同位置的冠状和轴向参数无明显变化。
结论：在胸椎侧凸患者中，代偿矢状面伸直可以观察到轻微增加的胸腰椎后凸，特别是当从站立姿势过渡到坐姿时，由于骨盆向后旋转。我们的结果强调，仅使用站立X射线并不能完全分析AIS中带有支具治疗的矢状对齐。
背景：研究方案已在中国临床试验注册中心（ChiCTR1800018310）注册。
方法：我们评估了接受保守治疗的胸廓弯曲患者的单中心队列（32例具有LenkeI曲线的AIS患者）。在他们第一次就诊和支撑后，使用EOS成像系统分析了他们站立和坐姿的3D参数。
结果：患者首次就诊时，矢状面参数，如胸椎后凸（TK），腰椎前凸(LL),从站立姿势过渡到坐姿时，骶骨坡度减小(站立29°±6°，42°±8°,和42°±8°vs.坐22°±5°，27°±6°,和24°±4°；p<0.001)，而骨盆倾斜（PT）增加，矢状垂直轴向前移动（站立9°±6°和1.6±2.7cmvs.坐24°±4°和3.8±2.3厘米；p<0.001）。支撑之后,TK和LL略有下降（从29°±6°和42°±8°下降到23°±3°和38°±6°；p<0.001），而胸腰椎交界处（TLJ）值增加（从3°±3°增加到11°±3°；p<0.001）。当过渡到坐姿时，在第一次访问中观察到类似的特征，除了TLJ和PT值的细微增加（站立11°±3°和9°±4°与坐14°±3°和28°±4°；p<0.001)。此外，同时测量的不同位置的冠状和轴向参数无明显变化。
结论：在胸椎侧凸患者中，代偿矢状面伸直可以观察到轻微增加的胸腰椎后凸，特别是当从站立姿势过渡到坐姿时，由于骨盆向后旋转。我们的结果强调，仅使用站立X射线并不能完全分析AIS中带有支具治疗的矢状对齐。
背景：研究方案已在中国临床试验注册中心（ChiCTR1800018310）注册。
