| Objective:1.To measure the internal and external diameter and height of thoracic pedicle in adolescent idiopathic scoliosis patients aged 11-18 years by imaging technology,and to summarize the variation characteristics of pedicle related parameters through data analysis;2.To study pedicle classification by combining the obtained data and pedicle morphology,and to explore the characteristics and variation rules of pedicle classification.Methods:1.From 2012 to 2018,30 cases of adolescent idiopathic scoliosis,aged 11-18 years,were selected from the medical imaging department of the Second Affiliated Hospital and the Fourth Affiliated Hospital of Inner Mongolia Medical University.Among them,9(30%)were males and 21(70%)were females.After three-dimensional reconstruction of CT,T1-T1 was measured by grouping convex and concave scoliosis.2.The internal and external transverse diameters of pedicle,the internal and external height of pedicle,were analyzed by statistical software,and the differences and changing rules of convex and concave sides were summarized.2.According to the measured transverse diameter and morphological changes of pedicle,combined with Fu Changfeng and Liu Yi's perfect pedicle morphological classification system based on Lenke classification,720 pedicles of 30 cases were classified.Results:1.The bilateral pedicles of adolescent idiopathic scoliosis have obvious asymmetry in the apical region.Compared with the convex region,the internal and external diameter of the pedicle in the concave axis of the apical region are significantly smaller than those in the convex region;the internal and external diameter of the pedicle have the same changing trend,and the internal and external height of the pedicle are also larger.The internal and external transverse diameters of the convex pedicle decreased gradually in T1-T4,then increasedgradually to T12,and the internal and external transverse diameters of the concave pedicle decreased from T1 to T7,and then increased gradually;the internal and external height of the convex pedicle showed the same change characteristics,showing a wavy increase from T1-T12;the internal and external height of the concave pedicle increased and decreased in T1-T3.As small as T4,slightly increased to T5,then decreased to T7,and then increased to T12.The parameters of pedicle were the smallest in the concave side of the parietal vertebral region.2.Combining the transverse diameter and morphology of pedicle in 30 cases of AIS,according to the classification system,type A(normal type),type B(narrow type),type C(isthmic sclerosis type),type D(complete sclerosis type),type E(pedicle absence type).There were 372,275,57,16 and 0 pedicles of thoracic vertebrae in A,B,C,D and E,respectively,totaling 720 pedicles.The total deformity rate of pedicle(B_E)was 48.33%,the rate of thoracic pedicle deformity of the convex and concave vertebral body increased(41.39% < 55.28%,P < 0.001);(? 60 °)group,(60 ° ~ 80 °)group and(? 80 °)group between the thoracic vertebrae The pedicle deformity rate increased in turn(40.38%<50.83%<59.52%,P<0.001).Conclusions:1.The differences of pedicle parameters in concave and convex sides and the variation of each parameter provide some guidance for the implantation and selection of pedicle screw in the clinical application of pedicle screw internal fixation for the treatment of idiopathic scoliosis.2.In adolescent idiopathic scoliosis patients,the rate of pedicle deformity in convex side is significantly less than that in concave side;and with the increase of Cobb angle,the rate of pedicle deformity is increasing significantly;in the treatment of adolescent idiopathic scoliosis,according to the different scoliosis and the severity of scoliosis,the types of pedicle are different,the appropriate pedicle screw and surgical methods are selected.It has certain guiding significance... |
PDF Full Text Request