RADIOGRAPHICAL ANALYSIS OF FLEXIBILITY OF IDIOPATIC SCOLIOSIS IN PRONO AND SUPINO

ABSTRACT Objective To determine if there is a statistically significant difference in the flexibility of the curves in the adolescent idiopathic scoliosis (AIS) by using lateral inclination radiographs in supine or prone decubitus. Methods We evaluated 19 patients with AIS, waiting for surgery. Radiographs of the patients were performed in orthostatic anteroposterior incidences and right and left lateral inclinations in prone and supine decubitus. The comparison between prone and supine decubitus was performed through the flexibility rates of the curves measured in each position. Results The mean flexibility rates measured in lateral inclination radiographs with the patient in the supine position were 54.4% ± 38.8% in the proximal thoracic curve, 45.8% ± 15.6% in the main thoracic curve, and 80.5% ± 20.7% in the thoracolumbar / lumbar curve. When the lateral inclination radiographs were performed with the patient in the prone position, we observed mean flexibility rates of 66.4% ± 34.3% in the proximal thoracic curve, 50.1% ± 12.8% in the main thoracic curve, and 80.6% ± 19.0% in the thoracolumbar / lumbar curve. Conclusion This present study did not find a statistically significant difference between the flexibility rates of the curves in the prone and supine positions, suggesting that the two radiographic methods analyzed are similar in the evaluation of the flexibility of the curves in adolescent idiopathic scoliosis. Level of evidence II; Development of diagnostic criteria in consecutive patients (with “gold” reference standard applied).

摘要
目的 明确采用仰卧位与俯卧位侧屈位X线片检测时，青少年特发性脊柱侧凸（adolescent idiopathic scoliosis, AIS）患者的脊柱曲度柔韧性是否存在统计学差异。
方法 本研究纳入19例拟接受手术治疗的青少年特发性脊柱侧凸患者，对其拍摄站立位前后位X线片，以及俯卧位、仰卧位的左右侧屈位X线片。通过测量不同体位下脊柱曲度的柔韧性比率，对比俯卧位与仰卧位的检测结果。
结果 患者仰卧位侧屈位X线片测量所得的平均柔韧性比率：近端胸曲为54.4%±38.8%，主胸曲为45.8%±15.6%，胸腰段/腰段曲度为80.5%±20.7%。采用俯卧位侧屈位X线片测量时，近端胸曲的平均柔韧性比率为66.4%±34.3%，主胸曲为50.1%±12.8%，胸腰段/腰段曲度为80.6%±19.0%。
结论 本研究未发现俯卧位与仰卧位检测下的脊柱曲度柔韧性比率存在统计学差异，提示两种X线摄片方法在评估青少年特发性脊柱侧凸的脊柱曲度柔韧性时效果相近。
证据等级 Ⅱ级；连续性患者诊断标准开发（采用"金标准"作为参照）。