Abstract：Objective To compare the occipitocervical sagittal alignment in normal adolescents and age- and gender-matched patients with adolescent idiopathic scoliosis (AIS) and analyze the relationship between occipitocervical parameters and cervical sagittal balance.Methods A total of 100 adolescent volunteers and 80 patients with AIS at the Affiliated Drum Tower Hospital of Nanjing University Medical School from March 2012 to March 2014 were recruited. Occipital incidence (OI), occipital slope (OS), occipital tilt (OT), C0-C2 angle, C2-C7 angle and C0-C7 angle were measured on sagittal occipitocervical image. The occipitocervical parameters were compared between the two groups and the relationship with age and gender was further evaluated.Correlations between occipitocervical parameters and cervical sagittal alignment in two groups were analyzed with Pearson coefficient.Results The mean OI, OS, OT were 36.12° ± 2.55° (30°-44°), 26.34° ± 8.41° (15°-46°), -10.06° ± 7.51° (-22°-11°) in normal group and 35.62° ± 3.01° (31°-42°), 24.27° ± 8.49° (7°- 42°), -11.52° ± 9.23°(-28° -10°) in AIS group, respectively. Occipitocervical parameters in two groups were not significantly different (t=0.878, t=1.014, t=1.306, all P values>0.05). Furtherly, no significant differences were noted between males and females, or between younger (≤14 years) and older subjects (>14 years) (all P values>0.05). Significant correlations were observed between OI and C0-C2 angle(r=0.307, P＜0.05), OI and C0-C7 angle(r=0.298, P＜0.05), OS and C2-C7 angle(r=0.402, P＜0.05), OS and C0-C7 angle(r=0.560, P＜0.05), OT and C2-C7 angle(r=0.428, P＜0.05) and OT and C0-C7 angle(r=0.550, P＜0.05) in normal group. However, only the correlations between OI and C0-C2 angle(r=0.532, P＜0.05), OS and C0-C2 angle(r=0.620, P＜0.05) were significant in AIS group.Conclusions There is no significant difference in occipitocervical parameter between normal adolescents and those with AIS, with no influence by age and gender. OI, OS and OT are significantly correlated with cervical sagittal alignment in normal adolescents. However, the occipitocervical parameters are only correlated with the upper cervical sagittal alignment in patients with AIS.
朱卫国,刘臻,朱泽章,张文,沙士甫,邱勇. 正常青少年及青少年特发性脊柱侧凸患者枕颈部矢状面形态相关研究[J]. 中华解剖与临床杂志, 2014, 19(5): 353-357.
Zhu Weiguo, Liu Zhen, Zhu Zezhang, Zhang Wen, Sha Shifu, Qiu Yong. Occipitocervical sagittal alignment in normal adolescents and adolescents with idiopathic scoliosis. Chinese Journal of Anatomy and Clinics, 2014, 19(5): 353-357.
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