358例无脊柱畸形汉族儿童与青少年胸、腰椎脊椎数目的变异率及其分布

The prevalence and distribution of thoracic and lumbar vertebral numerical variation in the juveniles and adolescents without spinal deformities in Han population of Jiangsu

目的：分析江苏省3~18岁无脊柱畸形汉族儿童与青少年胸椎、腰椎脊椎数目变异的发生率及分布情况，增强脊柱外科医生对胸、腰椎脊椎数目变异的认识。方法：对我科2006年1月~2014年2月收集的358例江苏省3~18岁无脊柱畸形汉族儿童与青少年的站立位全脊柱正侧位X线片进行回顾性分析。其中男性176例，女性182例。对所有入选者的站立位全脊柱正侧位X线片上的胸椎和腰椎脊椎数目进行计数，并记录所有入选者脊椎数目变异的分布情况，以统计其发生率。将胸椎和腰椎中不同变异类型的发生率行统计学分析以明确是否存在差异。结果：共33例无脊柱畸形汉族儿童与青少年存在胸椎和腰椎脊椎数目变异，发生率为9.2%（33/358）。其中存在胸椎脊椎数目变异者19例（5.3%），18例（5.0%）为11节胸椎，1例（0.2%）为13节胸椎；存在腰椎脊椎数目变异者18例（5.0%），17例（4.7%）为6节腰椎，1例（0.2%）为4节腰椎。经卡方检验，11节胸椎和6节腰椎的发生率分别较13节胸椎和4节腰椎的发生率高（均P〈0.05）。胸椎＋腰椎合计16节的变异率为3.9%（14/358），胸椎＋腰椎合计18节的变异率为4.2%（15/358）。4例（1.1%）为混合型脊椎数目变异，均表现为11节胸椎和6节腰椎。结论：在江苏省无脊柱畸形汉族儿童与青少年中，9.2%的人群存在胸腰椎脊椎数目变异，其中11节胸椎及6节腰椎这两种变异情况比较多见。

Objectives： To detect the prevalence and distribution of thoracic and lumbar vertebral numerical variation in the juveniles and adolescents without spinal deformities in Jiangsu, and thus to increase awareness of vertebral numerical variation among the spine surgeons. Methods： A retrospective review of radiographs of 358 juveniles and adolescents without spinal deformities and aged between 3 and 18 in Jiangsu was performed. The study including 176 males and 182 females with standing full-spine radiography was reviewed to assess the number of thoracic and lumbar vertebrae. The prevalence and the distribution of the variation were recorded. The Chi-square test was used to detect the differences among the different types of variation in thoracic and lumbar vertebrae. Results： 9.2% of the subjects（thirty-three） had an atypical number of vertebrae in the thoracic and/or lumbar spine. Nineteen subjects（5.3%） had an atypical number of thoracic vertebrae, eighteen（5.0%） had eleven thoracic vertebrae and only 1 subject（0.2%） had thirteen thoracic vertebrae. Eighteen subjects（5.0%） had an atypical number of lumbar vertebrae, among whom one（0.2%） has four lumbar vertebrae and seventeen（4.7%） have six. The prevalence of variation of 11 thoracic vertebrae and 6 lumbar vertebrae was higher than that of the 13 thoracic vertebrae and 4 lumbar vertebrae respectively（P〈0.05）. Fourteen（3.9%） subjects had 16 thoracic and lumbar vertebrae and fifteen（4.2%） subjects had 18 thoracic and lumbar vertebrae. Multilevel vertebral anomalies were present in 1.1% of the subjects（four of 358）, with 11 thoracic vertebrae and 6 lumbar vertebrae for all. Conclusions： The variation of the number of thoracic or lumbar vertebrae was found in 9.2% juveniles and adolescents without spinal deformities, with a higher possibility of variable 11 thoracic or 6 lumbar vertebrae in Han population of Jiangsu.