矢状脊柱-骨盆排列是小儿脊柱病理中下腰痛的原因吗?复习一下。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-11-24 eCollection Date: 2023-12-01 DOI:10.1177/18632521231215853
Czubak-Wrzosek Maria, Wrzosek Patryk, Żebrowski Mateusz, Tyrakowski Marcin
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引用次数: 0

摘要

目的:在生长过程中观察到许多脊柱病变发生时脊柱骨盆形态的改变。本研究的目的是为了更好地了解矢状面代偿机制及其对选定的儿童脊柱病变疼痛发生的可能影响。方法:在PubMed数据库中检索1965年9月至2023年7月间发表的文献。搜索中包含的关键词是“脊柱裂”、“脊椎滑脱”、“脊柱侧凸”、“后凸”、“矢状”、“儿科”、“儿童”、“青少年”、“成长”、“发育”和“疼痛”。结果:特发性脊柱侧凸中矢状面排列模式的多样性最大,脊柱整体变平最常见。生长过程中发生的后凸变形的特征是结构性胸部或胸腰椎后凸,由腰椎前凸过大和骨盆发生率较低代偿。而在脊柱滑脱中,观察到脊柱骨盆连接处的形态学改变,骨盆发生率高。在特发性脊柱侧凸中,疼痛似乎与矢状位排列无关。在Scheuermann病中,它定位于畸形的顶端,并与曲线模式相关,而在椎体滑脱中,矢状面对齐仅在严重滑移中与疼痛评分相关。结论:大多数生长过程中发生的脊柱疾病患者在临床上表现为矢状面平衡姿势。这表明骨骼发育成熟前的代偿机制非常重要。理解矢状面对齐脊柱畸形及其与疼痛的关系对于这些疾病的适当评估和治疗至关重要。
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Is sagittal spinopelvic alignment a cause of low back pain in pediatric spine pathologies? A review.

Purpose: Altered spinopelvic morphology is observed in many spine pathologies occurring during growth. The aim of the study is to better understand the sagittal compensatory mechanisms and their possible influence on the occurrence of pain in selected pediatric spine pathologies.

Methods: A bibliographic search in the PubMed database included articles published between September 1965 and July 2023. The keywords contained in the search were "spondylolysis," "spondylolisthesis," "scoliosis," "kypho," "sagittal," "pediatric," "child," "adolescent," "grow," "development," and "pain."

Results: The largest diversity in sagittal alignment patterns was reported in idiopathic scoliosis, with global flattening of the spine being the most common. Kyphotic deformations occurring during growth are characterized by structural thoracic or thoracolumbar kyphosis compensated by lumbar hyperlordosis and lower pelvic incidence. Whereas in spondylolisthesis, altered morphology of the spinopelvic junction with high values of pelvic incidence is observed. Pain does not seem to be related to sagittal alignment in idiopathic scoliosis. In Scheuermann disease, it is localized at the apex of the deformity and is associated with the curve pattern, whereas in spondylolisthesis, sagittal alignment correlates with pain scores only in high-grade slips.

Conclusion: Most of the patients with spine disorders that occurred during growth present a clinically balanced posture in the sagittal plane. It suggests that compensatory mechanisms before achieving skeletal maturity are really significant. A comprehension of sagittal alignment in spine deformities and its relationship to pain is essential for the proper assessment and treatment of these disorders.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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