Abstract：
OBJECTIVE: To observe the alteration of thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis(AIS) and the difference of physiological curvature between different types of scoliosis.
METHODS: A retrospective analysis was conducted on 305 adolescent patients taken full spine X-ray in our hospital from January 2017 to December 2021. The patients were divided into normal group and scoliosis group. The normal group was composed of 179 patients, 79 males and 100 females, aged 10 to 18 years old with an average of (12.84±2.10) years old, with cobb agle less than 10 degrees. The scoliosis group was composed of 126 patients, 33 males and 93 females, aged 10 to 18 years old with an average of (13.92±2.20) years old. The gender, age, Risser sign, thoracic kyphosis(TK) and lumbar lordosis(LL) in 2 groups were compared, and the TK and LL were also compared between different genders, different degrees of scoliosis and different segments of scoliosis.
RESULTS: The female ratio(P=0.001) and age (P<0.001) in scoliosis group were higher than them in normal group; the ratio of low-grade ossification was higher in normal group than in scoliosis group(P=0.038). TK was significantly smaller in scoliosis group than in normal group(P<0.001), but there was no significant difference in LL between the 2 groups(P=0.147). There were no significant difference in TK and LL between male and female. The TK was significantly bigger in mild AIS patients than in moderate AIS patients(P<0.05), but there was no significant difference in LL between mild and moderate patients(P>0.05). The TK and LL in different segments scoliosis were not found significant difference.
CONCLUSIONS: The physiological curvature of thoracic and lumbar spine is independent of gender. The thoracic physiological curvature becomes smaller in AIS patients, but lumbar curvature remains unchanged. The thoracic physiological curvature in mild AIS patients is greater than that in moderate AIS patients, but the lumbar curvature is almost unchanged between mild and moderate scoliosis and is similar with that in normal adolescent. The alteration of thoracic and lumbar physiological curvature in AIS patients may be related to relative anterior spinal overgrowth, and the specific detailed mechanism needs to be further studied.
METHODS: A retrospective analysis was conducted on 305 adolescent patients taken full spine X-ray in our hospital from January 2017 to December 2021. The patients were divided into normal group and scoliosis group. The normal group was composed of 179 patients, 79 males and 100 females, aged 10 to 18 years old with an average of (12.84±2.10) years old, with cobb agle less than 10 degrees. The scoliosis group was composed of 126 patients, 33 males and 93 females, aged 10 to 18 years old with an average of (13.92±2.20) years old. The gender, age, Risser sign, thoracic kyphosis(TK) and lumbar lordosis(LL) in 2 groups were compared, and the TK and LL were also compared between different genders, different degrees of scoliosis and different segments of scoliosis.
RESULTS: The female ratio(P=0.001) and age (P<0.001) in scoliosis group were higher than them in normal group; the ratio of low-grade ossification was higher in normal group than in scoliosis group(P=0.038). TK was significantly smaller in scoliosis group than in normal group(P<0.001), but there was no significant difference in LL between the 2 groups(P=0.147). There were no significant difference in TK and LL between male and female. The TK was significantly bigger in mild AIS patients than in moderate AIS patients(P<0.05), but there was no significant difference in LL between mild and moderate patients(P>0.05). The TK and LL in different segments scoliosis were not found significant difference.
CONCLUSIONS: The physiological curvature of thoracic and lumbar spine is independent of gender. The thoracic physiological curvature becomes smaller in AIS patients, but lumbar curvature remains unchanged. The thoracic physiological curvature in mild AIS patients is greater than that in moderate AIS patients, but the lumbar curvature is almost unchanged between mild and moderate scoliosis and is similar with that in normal adolescent. The alteration of thoracic and lumbar physiological curvature in AIS patients may be related to relative anterior spinal overgrowth, and the specific detailed mechanism needs to be further studied.
摘要：
目的：观察青少年特发性脊柱侧凸(AIS)胸腰段生理曲度的改变及不同类型脊柱侧凸的生理曲度差异。
方法：回顾性分析2017年1月至2021年12月在我院行脊柱全X线检查的305例青少年患者。将患者分为正常组和脊柱侧凸组。正常组由179例患者组成，79名男性和100名女性，年龄10至18岁，平均(12.84±2.10)岁，cobbagle低于10度。脊柱侧弯组由126例患者组成，33名男性和93名女性，年龄10~18岁,平均(13.92±2.20)岁。性别,年龄,Risser标志,比较2组胸椎后凸(TK)和腰椎前凸(LL),不同性别的TK和LL也进行了比较，不同程度的脊柱侧凸和不同节段的脊柱侧凸。
结果：脊柱侧凸组女性比例（P=0.001）和年龄（P<0.001）均高于正常组；正常组低度骨化率高于脊柱侧凸组（P=0.038）。脊柱侧凸组TK明显小于正常组(P<0.001),两组间LL差异无统计学意义(P=0.147)。TK和LL在男女间无显著差别。轻度AIS患者TK明显大于中度AIS患者(P<0.05),但轻度和中度患者的LL差异无统计学意义（P>0.05）。不同节段脊柱侧凸的TK和LL差异无统计学意义。
结论：胸椎和腰椎的生理曲度与性别无关。AIS患者的胸部生理曲率变小，但腰椎曲度保持不变。轻度AIS患者的胸部生理曲率大于中度AIS患者，但是轻度和中度脊柱侧凸之间的腰椎曲度几乎没有变化，并且与正常青少年相似。AIS患者胸腰椎生理曲度的改变可能与前路脊柱过度生长有关。具体的详细机制有待进一步研究。
方法：回顾性分析2017年1月至2021年12月在我院行脊柱全X线检查的305例青少年患者。将患者分为正常组和脊柱侧凸组。正常组由179例患者组成，79名男性和100名女性，年龄10至18岁，平均(12.84±2.10)岁，cobbagle低于10度。脊柱侧弯组由126例患者组成，33名男性和93名女性，年龄10~18岁,平均(13.92±2.20)岁。性别,年龄,Risser标志,比较2组胸椎后凸(TK)和腰椎前凸(LL),不同性别的TK和LL也进行了比较，不同程度的脊柱侧凸和不同节段的脊柱侧凸。
结果：脊柱侧凸组女性比例（P=0.001）和年龄（P<0.001）均高于正常组；正常组低度骨化率高于脊柱侧凸组（P=0.038）。脊柱侧凸组TK明显小于正常组(P<0.001),两组间LL差异无统计学意义(P=0.147)。TK和LL在男女间无显著差别。轻度AIS患者TK明显大于中度AIS患者(P<0.05),但轻度和中度患者的LL差异无统计学意义（P>0.05）。不同节段脊柱侧凸的TK和LL差异无统计学意义。
结论：胸椎和腰椎的生理曲度与性别无关。AIS患者的胸部生理曲率变小，但腰椎曲度保持不变。轻度AIS患者的胸部生理曲率大于中度AIS患者，但是轻度和中度脊柱侧凸之间的腰椎曲度几乎没有变化，并且与正常青少年相似。AIS患者胸腰椎生理曲度的改变可能与前路脊柱过度生长有关。具体的详细机制有待进一步研究。
