PDF(Pubmed)
Abstract：
BACKGROUND: In idiopathic scoliosis, the anterior spinal column has rotated away from the midline and has become longer through unloading and expansion of the intervertebral discs. Theoretically, extension of the spine in the sagittal plane should provide room for this longer anterior spinal column, allowing it to swing back towards the midline in the coronal and axial plane, thus reducing both the Cobb angle and the apical vertebral rotation.
METHODS: In this prospective experimental study, ten patients with primary thoracic adolescent idiopathic scoliosis (AIS) underwent MRI (BoneMRI and cVISTA sequences) in supine as well as in an extended position by placing a broad bolster, supporting both hemi-thoraces, under the scoliotic apex. Differences in T4-T12 kyphosis angle, coronal Cobb angle, vertebral rotation, as well as shape of the intervertebral disc and shape and position of the nucleus pulposus, were analysed and compared between the two positions.
RESULTS: Extension reduced T4-T12 thoracic kyphosis by 10° (p < 0.001), the coronal Cobb angle decreased by 9° (p < 0.001) and vertebral rotation by 4° (p = 0.036). The coronal wedge shape of the disc significantly normalized and the wedged and lateralized nucleus pulposus partially reduced to a more symmetrical position.
CONCLUSIONS: Simple extension of the scoliotic spine leads to a reduction of the deformity in the coronal and axial plane. The shape of the disc normalizes and the eccentric nucleus pulposus partially moves back to the midline.
METHODS: In this prospective experimental study, ten patients with primary thoracic adolescent idiopathic scoliosis (AIS) underwent MRI (BoneMRI and cVISTA sequences) in supine as well as in an extended position by placing a broad bolster, supporting both hemi-thoraces, under the scoliotic apex. Differences in T4-T12 kyphosis angle, coronal Cobb angle, vertebral rotation, as well as shape of the intervertebral disc and shape and position of the nucleus pulposus, were analysed and compared between the two positions.
RESULTS: Extension reduced T4-T12 thoracic kyphosis by 10° (p < 0.001), the coronal Cobb angle decreased by 9° (p < 0.001) and vertebral rotation by 4° (p = 0.036). The coronal wedge shape of the disc significantly normalized and the wedged and lateralized nucleus pulposus partially reduced to a more symmetrical position.
CONCLUSIONS: Simple extension of the scoliotic spine leads to a reduction of the deformity in the coronal and axial plane. The shape of the disc normalizes and the eccentric nucleus pulposus partially moves back to the midline.
摘要：
背景：在特发性脊柱侧凸中，前脊柱旋转远离中线，并通过椎间盘的卸载和扩张而变得更长。理论上,脊柱在矢状面的延伸应该为这个较长的前脊柱提供空间，允许它在冠状面和轴向面朝中线摆动，从而减少Cobb角和根尖椎体旋转。
方法：在本前瞻性实验研究中，10例原发性胸部青少年特发性脊柱侧凸(AIS)患者在仰卧位以及在伸展位置通过放置一个宽的垫进行了MRI(BoneMRI和cVISTA序列),支持两个半边带，在脊柱侧凸顶点下。T4-T12后凸角度的差异，冠状Cobb角,椎骨旋转,以及椎间盘的形状和髓核的形状和位置，对这两个位置进行了分析和比较。
结果：延长使T4-T12胸椎后凸减少10°（p<0.001），冠状Cobb角减小9°（p<0.001），椎体旋转4°（p=0.036）。椎间盘的冠状楔形显着正常化，楔形和偏侧的髓核部分减少到更对称的位置。
结论：脊柱侧凸的简单延伸导致冠状和轴向平面的畸形减少。椎间盘的形状恢复正常，偏心髓核部分移回中线。
方法：在本前瞻性实验研究中，10例原发性胸部青少年特发性脊柱侧凸(AIS)患者在仰卧位以及在伸展位置通过放置一个宽的垫进行了MRI(BoneMRI和cVISTA序列),支持两个半边带，在脊柱侧凸顶点下。T4-T12后凸角度的差异，冠状Cobb角,椎骨旋转,以及椎间盘的形状和髓核的形状和位置，对这两个位置进行了分析和比较。
结果：延长使T4-T12胸椎后凸减少10°（p<0.001），冠状Cobb角减小9°（p<0.001），椎体旋转4°（p=0.036）。椎间盘的冠状楔形显着正常化，楔形和偏侧的髓核部分减少到更对称的位置。
结论：脊柱侧凸的简单延伸导致冠状和轴向平面的畸形减少。椎间盘的形状恢复正常，偏心髓核部分移回中线。
