摘要
目的探讨小脑扁桃体位置在I临床诊治大弯度青少年特发性脊柱侧凸（adolescentidio—pathicscoliosis，AIS）中的意义。方法AIS患者203例，男27例，女176例；年龄平均（14．6±1．6）岁；Cobb角平均55．3°±16．6°。对照组86例，男、女各43例，年龄平均（15．7±1．8）岁，均未患有大脑、中脑、小脑、脊髓病变及脊柱侧凸、后凸和脊柱发育异常等。在MRI图像上测量AIS患者和对照组青少年的小脑扁桃体位置，分析二组之间的差异，以及年龄和性别对小脑扁桃体位置的影响。在AIS组内分析不同侧凸角度和侧凸类型患者的小脑扁桃体位置的差异。结果AIS患者的小脑扁桃体平均位置明显低于对照组（分别为枕骨大孔上0．9mm和2．9mm）。AIS患者中小脑扁桃体异位的发生率（34．5％）明显高于正常对照组（5．8％）。年龄、性别和Cobb角对小脑扁桃体位置均无显著的影响。在不同的侧凸类型中，双胸弯AIS患者小脑扁桃体异位的发生率（62．5％）最高。腰部侧凸的患者中小脑扁桃体异位发生率显著低于胸和胸腰部侧凸的患者。结论大弯度AIS患者的小脑扁桃体位置明显低于正常对照组。小脑扁桃体异位的发生率明显高于正常对照组。小脑扁桃体异位低于枕骨大孔2mm为异常，而在中国大陆此比例极低。AIS患者小脑扁桃体异位的发生可能与侧凸类型存在一定的关联。
Objective To explore the role of the cerebellar tonsil position in the diagnosis and treatment for AIS. Methods 203 AIS patients with a Cobb angle greater than 40° on coronal plane were ineluded. There were 27 boys and 176 girls,with a mean age of （14.6±1.6） year and a mean Cobb angle of 55.3°±16.6°. Eighty-six age-matched healthy adolescents, consisted of 43 boys and 43 girls, were recruited to serve as controls, after exclusion of the diseases or disorders in brain, brainstem, cerebella and spinal cord, as well as spine deformities such as seoliosis, kyphosis and spinal dysplasia. Sagittal MRI of hindbrain was performed on both of AIS patients and healthy controls. The position of the eerebellar tonsil was defined as tonsilar eetopia when it located below the line connecting the basion and opisthion（BO line）. Results In AIS patients and healthy controls, the mean position of the eerebellar tonsil was 0.9 and 2.9 mm above the BO line, respectively. The incidence of tonsillar eetopia in AIS was found to be significantly higher than healthy adolescents （ratio 34.5% versus 5.8%）. No significant correlations were found between the position of the eerebollar tonsil with age or sex in AIS and control subjects. It was shown the position of the eerebellar tonsil was not significantly deferent among AIS patients with deferent curve severity. However, it was noted that there was a highest incidence （62.5%） of tonsillar eetopia in atypical seoliotie eases with a double thoracic curve. Additionally, a significant higher incidence of tonsillar eetopia was found in patients with thoracic or thoraeolumbar curves when compared to those with lumbar curves. Conclusion There was a relatively lower position of the eerebellar tonsil together with a significant higher incidence of tonsil eetopia in AIS patients. Tonsillar eetopia above 2 mm in AIS patients should be regarded as abnormal. A lower position of the eerebellar tonsil is associated with the curve pattern of AIS, which might contribute to better underst
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2007年第2期96-100,共5页
Chinese Journal of Orthopaedics
基金
江苏省南京市卫生局专项基金（ZKX05016）
关键词
脊柱侧凸
扁桃体
磁共振成像
青少年
Scoliosis
Tonsil
Magnetic resonance imaging
Adolescent
