Relation between spine alignment and scapular position by plain radiograph examination

Q4 Medicine
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引用次数: 0

Abstract

Background

Both scapular dynamics and static scapular position are important in the treatment of shoulder dysfunction. This study aimed to create an index that can evaluate scapular position on plain radiographs and evaluate the relation between scapular position and posture accurately.

Methods

Using four fresh frozen cadavers, we developed a glenoid angle grade based on the degree of overlap between the shadow of the coracoid inflection point and the upper edge of the scapula on frontal plain radiographs: grade 1, no overlap; grade 2, overlaps by less than half of the shadow; grade 3, overlaps by more than half. We then performed a retrospective cohort study that included 329 shoulders of 329 patients who underwent spine surgery. Spine alignment parameters (SPAPs), including cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence, pelvic tilt, sacral slope, and sagittal vertical axis were measured on standing lateral plain radiographs. Glenoid anterior tilt (GAT) and glenoid anteversion angle (GAVA) were calculated on frontal radiographs and three-dimensional computed tomography scans. Correlations between SPAPs and each angle were investigated, and independent influencing factors were sought in multivariate analysis. Individual factors, GAT, GAVA, and SPAPs were compared among the grades.

Results

SPAPs associated with GAT were sagittal vertical axis (R = 0.14, P = .011), TK (R = 0.12, P = .026), and LL (R = −0.11, P = .046). Multivariate analysis identified TK and LL as independent influencing factors (TK, P = .001; LL, P = .008). SPAPs associated with GAVA were CL (R = 0.17, P = .002), TK (R = 0.29, P < .001), and LL (R = 0.25, P < .001). Multivariate analysis identified CL, TK, and LL as independent influencing factors (CL, P = .01; TK, P = .03; LL, P = .03). There were 183, 127, and 19 cases categorized as grades 1, 2, and 3. GAT (grade 1, 24.0 ± 7.8; 2, 32.4 ± 7.0; 3, 41.0 ± 7.8), GAVA (1, 29.3 ± 7.6; 2, 33.7 ± 9.5; 3, 31.5 ± 8.3), and TK (1, 30.6 ± 13.6; 2, 35.1 ± 14.2; 3, 43.1 ± 20.4) differed significantly according to grade.

Conclusion

We identified factors that influence scapular position and demonstrated that scapular position can be estimated by a grading system using plain radiographs.

通过平片检查脊柱排列与肩胛骨位置之间的关系
背景肩胛骨动态和静态肩胛骨位置对肩关节功能障碍的治疗都很重要。方法利用四具新鲜冰冻尸体,我们根据正面平片上肩胛骨拐点阴影与肩胛骨上缘之间的重叠程度制定了盂角分级:1级,无重叠;2级,重叠不到阴影的一半;3级,重叠超过一半。我们随后进行了一项回顾性队列研究,其中包括 329 名接受脊柱手术患者的 329 个肩部。我们在站立侧位平片上测量了脊柱排列参数(SPAPs),包括颈椎前凸(CL)、胸椎后凸(TK)、腰椎前凸(LL)、骨盆入射角、骨盆倾斜、骶骨斜度和矢状纵轴。盂状体前倾(GAT)和盂状体前倾角(GAVA)通过正面X光片和三维计算机断层扫描进行计算。研究了 SPAP 与各角度之间的相关性,并在多变量分析中寻找独立的影响因素。结果与GAT相关的SPAP有矢状纵轴(R = 0.14,P = .011)、TK(R = 0.12,P = .026)和LL(R = -0.11,P = .046)。多变量分析确定 TK 和 LL 为独立影响因素(TK,P = .001;LL,P = .008)。与 GAVA 相关的 SPAP 为 CL(R = 0.17,P = .002)、TK(R = 0.29,P < .001)和 LL(R = 0.25,P < .001)。多变量分析发现,CL、TK 和 LL 是独立的影响因素(CL,P = .01;TK,P = .03;LL,P = .03)。分为 1 级、2 级和 3 级的病例分别为 183 例、127 例和 19 例。GAT(1 级,24.0 ± 7.8;2 级,32.4 ± 7.0;3 级,41.0 ± 7.8)、GAVA(1 级,29.3 ± 7.6;2 级,33.7 ± 9.5;3 级,31.5 ± 8.3)和 TK(1 级,30.6 ± 13.6;2 级,35.1 ± 14.2;3 级,43.1 ± 20.4)在等级上有显著差异。结论我们确定了影响肩胛骨位置的因素,并证明肩胛骨位置可通过使用平片的分级系统进行估计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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0.60
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