躯干中轴线在脊柱失稳定评价中的应用

An Application Study of Trunk Axis Line Measurement in Scoliosis Evaluation

目的探讨躯干中轴线（trunk axis line，TAL）在脊柱侧凸和躯干倾斜诊断和治疗中的临床应用价值。方法选择2006年6月到8月间42例特发性脊柱侧凸患者。a）通过测量侧凸顶椎偏离TAL的距离来评价侧凸程度。b）通过测量TAL与重垂线的夹角来评价躯干倾斜，以倾斜角0°～1°为正常，大于1°为失平衡。结果42例患者主弯顶椎偏离TAL距离均大于1cm，范围为（1．22～8．30）cm，平均（4．35±1．64）cm，其中24例存在躯干倾斜（24／42，57．1％），倾斜角度1．41°～9．52°，平均（3．77±1．52）°。以骨盆为参照，躯干左侧倾斜18例（18／42，75％），右侧倾斜6例（6／24，25％）。结论在脊柱全长片上，根据TAL对冠状面上的躯干倾斜和脊柱侧凸进行诊断和评价是可行的，也有助于侧凸分型，以及顶椎、端椎和稳定椎的确定等，所以该方法值得研究和临床试用。

Objective To study the clinical application value of trunk axis line（TAL） measurement in diagnoses and therapy of scoliosis and trunk imbalance. Methods 42 cases of idiopathic scoliosis were recruited from June to August 2006. a）The trunk imbalance was defined by measuring the angle between TAL. and the vertical line. The normal range of the angle was 0- 1 while the abnormity was more than 1. b）The scoliosis severity was evaluated by measuring the distance between TAL. and the apical vertebra of the curve. Results a）The distance between TAL and the apical vertebra of the curve was more than 1 cm in all 42 cases. Its range was 1.22-8.30 cm （mean 4.35±1.64 cm）. b ）24 cases （24/42,57. 1% ） with trunk imbalance were diagnosed. The imbalanced angles＇ range was 1.41 - 9. 52 （mean3.77°± 1.52°）. Contrasting to the pelvic bone,the trunk shifted to the left in 18 cases （18/24,75 % ）,and to the right in 6 cases（6/24,25% ）. Conclusion In a whole spine X-ray film,TAL can be used in diagnoses and evaluation of trunk imbalance and scoliosis at the same time. It also helps grouping in scoliosis and confirming the locations of apical vertebra,end vertebra and stabilized vertebra. So TAL is worthy of advanced research and clinical application.