Résumé
Afin d'étudier le développement de la rotation axiale des vertèbres dans la scoliose débutante, l'angle de rotation vertébrale (VRA) a été mesuré sur 132 clichés de face réalisés, chez des patients porteurs d'une scoliose diagnostiquée ou suspectée. La rotation a été mesurée sur la vertèbre sommet et les deux vertèbres sus-et sous-jacentes. Le matériel d'étude comportait un groupe témoin et 3 groupes de scolioses dont l'angle de Cobb variait de 4° à 30°. Dans le groupe témoin une discrète rotation vertébrale a été retrouvée, le plus souvent vers la droite. Dans les groupes de scolioses, la rotation était la plus marquée dans les segments apicaux. La valeur moyenne de l'angle de rotation vers la convexité était significativement augmentée au niveau de la vertèbre située immédiatement au dessus de l'apex des courbures dont l'angle de Cobb était compris entre 8° et 15°, et au niveau des 4 vertèbres crâniales dans les courbures dont l'angle de Cobb était compris entre 16° et 30°. Une rotation atypique vers le côté opposé à la courbure majeure a été observée dans 12,8% des cas. Il y avait une corrélation positive significative entre la VRA et l'angle de Cobb. Ces résultats montrent qu'une légère rotation vertébrale du côté droit est de constatation commune sur le rachis normal, et que la VRA augmente avec l'importance de la déviation latérale du rachis. En conclusion, la déformation frontale des scolioses idiopathiques débutantes est accompagnée et probablement couplée à la rotation vertébrale dans le plan horizontal.
Summary
In order to investigate the development of the vertebral axial rotation in patients with early scoliosis, the vertebral rotation angle (VRA) was quantified on the basis of 132 anteroposterior radiographs obtained from patients with diagnosed or suspected scoliosis. The rotation was measured in the apical vertebra and in the two suprajacent and two subjacent vertebrae. The radiographic material was divided into a control reference group and three scoliotic groups with varying Cobb angle from 4° up to 30°. In the reference group a slight vertebral rotation was significantly more often seen to the right. In the scoliotic groups, the rotation was most pronounced in the apical segments. The mean VRA toward the convex side was significantly increased in the vertebrae just suprajacent to the apex in curves with a Cobb angle of 8°–15° and in the cranial four vetebrae in curves with a Cobb angle of 16°–30°. Atypical vertebral rotation to the opposite side of the major curve was observed in 12.8% of the cases. There was a significant positive correlation between the VRA and the Cobb angle. These results show that a slight VRA to the right is a common feature in the normal spine, and that the VRA increases with progressive lateral deviation of the spine. It is concluded that the coronal plane deformity in early idiopathic scoliosis is accompanied and probably coupled to vertebral rotation in the horizontal plane.
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Xiong, B., Sevastik, J., Hedlund, R. et al. Segmental vertebral rotation in early scoliosis. Eur Spine J 2, 37–41 (1993). https://doi.org/10.1007/BF00301053
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DOI: https://doi.org/10.1007/BF00301053