中国部分地区汉族儿童和青少年脊柱矢状位参数变化

Development trends of spinal sagittal parameters in children and adolescents of Han nationality in partial Chinese regions

目的探讨中国部分地区汉族儿童和青少年脊柱矢状位参数正常值并阐明其随年龄的变化趋势。方法纳入2013年1月—2018年8月于河北中石油中心医院及海军军医大学长海医院就诊的656名无症状中国汉族儿童和青少年志愿者(4~18岁)。收集研究对象性别、年龄和Risser征分级等资料,通过站立位脊柱全长侧位X线片测量胸椎后凸角(TK)、腰椎前凸角(LL)、胸腰交界区后凸角(TLJA)、骨盆入射角(PI)、骶骨倾斜角(SS)、骨盆倾斜角(PT)、矢状位偏移(SVA)等参数。将研究对象按年龄分为4~6岁、7~9岁、10~12岁、13~15岁、16~18岁5组,比较矢状位参数随年龄变化的趋势。结果656名汉族儿童和青少年人群的TK为30.41°±10.44°,LL为49.95°±9.04°,TLJA为3.71°±7.55°,PI为41.84°±7.47°,SS为34.08°±6.49°,PT为7.76°±7.11°,SVA为(-0.01±21.57)mm。随着年龄增长,青少年的Risser征分级、PI及PT较儿童增大,差异均有统计学意义(P<0.05)。Risser征分级、PI、PT、SS、TK、LL的变化均与年龄变化有关(P<0.05),其中PI与年龄关系最为密切,随年龄增大而逐渐增大,并且在4~15岁时上升较快,在16~18岁时上升趋势减缓。结论中国部分地区汉族儿童和青少年脊柱矢状位参数随年龄增长而变化,其中PI随年龄增长而增大的规律最为明显。

Objective To investigate the normal values of sagittal parameters of spine in children and adolescents of Han nationality in partial Chinese regions,and clarify their development trends with age.Methods A total of 656 asymptomatic Chinese Han children and adolescents(aged 4-18)who visited Hebei Petro China Center Hospital and Changhai Hospital of Navy Medical University from January 2013 to August 2018 were included.Demographic data including gender,age and Risser’s sign grade were collected.The sagittal parameters,including thoracic kyphosis(TK),lumbar lordosis(LL),thoracolumbar junctional angle(TLJA),pelvic incidence(PI),sacral slope(SS),pelvic tilt(PT)and sagittal vertical axis(SVA)were measured on spine full length lateral roentgenograph in standing position.The subjects were divided into 5 groups according to age:4-6 years old,7-9 years old,10-12 years old,13-15 years old and 16-18 years old groups,and the changes of sagittal parameters with age were compared.Results The mean values of TK,LL,TLJA,PI,SS,PT and SVA in 656 normal Chinese Han children and adolescents were 30.41°±10.44°,49.95°±9.04°,3.71°±7.55°,41.84°±7.47°,34.08°±6.49°,7.76°±7.11°,and(-0.01±21.57)mm,respectively.With the increase of age,the Risser’s sign grade,PI and PT of adolescents were larger than those of children,and the differences were statistically significant(P<0.05).The changes of Risser’s sign grade,PI,PT,SS,TK and LL were related to age(P<0.05).Among them,PI is most closely related to age,and the rising trend was faster at 4-15 years old and slowed down at 16-18 years old.Conclusion The sagittal parameters of the spine in children and adolescents of Han nationality in partial Chinese regions change with age,and PI increased with age is the most obvious.