The association between variations in the number of thoracic and lumbar vertebrae and rib morphology in adolescent idiopathic scoliosis.

IF 1.6 Q3 CLINICAL NEUROLOGY Spine deformity Pub Date : 2024-09-01 Epub Date: 2024-05-09 DOI:10.1007/s43390-024-00887-y
Kotaro Sakashita, Toshiaki Kotani, Tsuyoshi Sakuma, Yasushi Iijima, Kohei Okuyama, Tsutomu Akazawa, Shohei Minami, Seiji Ohtori, Masao Koda, Masashi Yamazaki
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Abstract

Purpose: Preoperative counting of thoracic and lumbar vertebrae is crucial in adolescent idiopathic scoliosis (AIS) due to reported anatomical variations and potential surgical site misidentification. This study investigated characteristics associated with the vertebral number variations AIS, particularly focusing on rib morphology.

Methods: Based on three-dimensional computed tomography, patients were categorized into the non-variant number group, comprising individuals with 12 thoracic and 5 lumbar vertebrae, and the variant number group, comprising individuals with different numbers of vertebrae. Additionally, the most caudal rib morphology was classified as normal, unilateral, or hypoplastic.

Results: A total of 359 patients were included in our study (41 males, 318 females, age: 16.3 ± 3.1 years), with 44 patients (12.3%) assigned to the variant number group. Logistic regression analysis identified unilateral ribs (odds ratio [OR]: 10.50) and lumbosacral transitional vertebrae (LSTV) (OR 6.49) as significant risk factors associated with variations. Further analysis revealed hypoplastic ribs as a significant risk factor associated with LSTV (OR: 4.58). 8 CONCLUSION: Our study suggests that abnormal rib morphology may be associated with vertebral number variations. Close attention to rib morphology is, therefore, warranted in cases with atypical vertebral numbers. Accordingly, to ensure surgical safety and accuracy, spine surgeons must communicate these variations to the surgical team, standardize nomenclature for describing them, and intraoperatively verify fusion levels with them.

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青少年特发性脊柱侧凸的胸椎和腰椎数量变化与肋骨形态之间的关联。
目的:对青少年特发性脊柱侧弯症(AIS)患者而言,术前胸椎和腰椎的计数至关重要,因为据报道存在解剖变异和潜在的手术部位识别错误。本研究调查了与 AIS 椎体数目变异相关的特征,尤其侧重于肋骨形态:方法:根据三维计算机断层扫描,将患者分为非椎体数目变异组(包括 12 个胸椎和 5 个腰椎)和椎体数目变异组(包括不同数目的椎体)。此外,最尾端的肋骨形态被分为正常、单侧或发育不良:我们的研究共纳入了 359 名患者(41 名男性,318 名女性,年龄:16.3 ± 3.1 岁),其中 44 名患者(12.3%)被归入变异编号组。逻辑回归分析发现,单侧肋骨(几率比 [OR]:10.50)和腰骶过渡椎(LSTV)(OR:6.49)是与变异相关的重要风险因素。进一步分析发现,肋骨发育不良是与 LSTV 相关的重要风险因素(OR:4.58)。8 结论:我们的研究表明,肋骨形态异常可能与椎骨数目变异有关。因此,对于椎体数目不典型的病例,应密切关注肋骨形态。因此,为确保手术的安全性和准确性,脊柱外科医生必须与手术团队沟通这些变异,规范描述这些变异的术语,并在术中与他们一起验证融合水平。
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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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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