CAJ | 학술논문

目的：分析江苏省3~18岁无脊柱畸形汉族儿童与青少年胸椎、腰椎脊椎数目变异的发生率及分布情况，增强脊柱外科医生对胸、腰椎脊椎数目变异的认识。方法：对我科2006年1月~2014年2月收集的358例江苏省3~18岁无脊柱畸形汉族儿童与青少年的站立位全脊柱正侧位X线片进行回顾性分析。其中男性176例，女性182例。对所有入选者的站立位全脊柱正侧位X线片上的胸椎和腰椎脊椎数目进行计数，并记录所有入选者脊椎数目变异的分布情况，以统计其发生率。将胸椎和腰椎中不同变异类型的发生率行统计学分析以明确是否存在差异。结果：共33例无脊柱畸形汉族儿童与青少年存在胸椎和腰椎脊椎数目变异，发生率为9.2%（33/358）。其中存在胸椎脊椎数目变异者19例（5.3%），18例（5.0%）为11节胸椎，1例（0.2%）为13节胸椎；存在腰椎脊椎数目变异者18例（5.0%），17例（4.7%）为6节腰椎，1例（0.2%）为4节腰椎。经卡方检验，11节胸椎和6节腰椎的发生率分别较13节胸椎和4节腰椎的发生率高（均P<0.05）。胸椎+腰椎合计16节的变异率为3.9%（14/358），胸椎+腰椎合计18节的变异率为4.2%（15/358）。4例（1.1%）为混合型脊椎数目变异，均表现为11节胸椎和6节腰椎。结论：在江苏省无脊柱畸形汉族儿童与青少年中，9.2%的人群存在胸腰椎脊椎数目变异，其中11节胸椎及6节腰椎这两种变异情况比较多见。
목적：분석강소성3~18세무척주기형한족인동여청소년흉추、요추척추수목변이적발생솔급분포정황，증강척주외과의생대흉、요추척추수목변이적인식。방법：대아과2006년1월~2014년2월수집적358례강소성3~18세무척주기형한족인동여청소년적참립위전척주정측위X선편진행회고성분석。기중남성176례，녀성182례。대소유입선자적참립위전척주정측위X선편상적흉추화요추척추수목진행계수，병기록소유입선자척추수목변이적분포정황，이통계기발생솔。장흉추화요추중불동변이류형적발생솔행통계학분석이명학시부존재차이。결과：공33례무척주기형한족인동여청소년존재흉추화요추척추수목변이，발생솔위9.2%（33/358）。기중존재흉추척추수목변이자19례（5.3%），18례（5.0%）위11절흉추，1례（0.2%）위13절흉추；존재요추척추수목변이자18례（5.0%），17례（4.7%）위6절요추，1례（0.2%）위4절요추。경잡방검험，11절흉추화6절요추적발생솔분별교13절흉추화4절요추적발생솔고（균P<0.05）。흉추+요추합계16절적변이솔위3.9%（14/358），흉추+요추합계18절적변이솔위4.2%（15/358）。4례（1.1%）위혼합형척추수목변이，균표현위11절흉추화6절요추。결론：재강소성무척주기형한족인동여청소년중，9.2%적인군존재흉요추척추수목변이，기중11절흉추급6절요추저량충변이정황비교다견。
Objectives: To detect the prevalence and distribution of thoracic and lumbar vertebral numerical variation in the juveniles and adolescents without spinal deformities in Jiangsu, and thus to increase aware-ness of vertebral numerical variation among the spine surgeons. Methods: A retrospective review of radio-graphs of 358 juveniles and adolescents without spinal deformities and aged between 3 and 18 in Jiangsu was performed. The study including 176 males and 182 females with standing full-spine radiography was re-viewed to assess the number of thoracic and lumbar vertebrae. The prevalence and the distribution of the variation were recorded. The Chi-square test was used to detect the differences among the different types of variation in thoracic and lumbar vertebrae. Results: 9.2% of the subjects(thirty-three) had an atypical number of vertebrae in the thoracic and/or lumbar spine. Nineteen subjects(5.3%) had an atypical number of thoracic vertebrae, eighteen(5.0%) had eleven thoracic vertebrae and only 1 subject(0.2%) had thirteen thoracic verte-brae. Eighteen subjects(5.0%) had an atypical number of lumbar vertebrae, among whom one(0.2%) has four lumbar vertebrae and seventeen (4.7%) have six. The prevalence of variation of 11 thoracic vertebrae and 6 lumbar vertebrae was higher than that of the 13 thoracic vertebrae and 4 lumbar vertebrae respectively ( P<0.05). Fourteen(3.9%) subjects had 16 thoracic and lumbar vertebrae and fifteen(4.2%) subjects had 18 tho-racic and lumbar vertebrae. Multilevel vertebral anomalies were present in 1.1% of the subjects(four of 358), with 11 thoracic vertebrae and 6 lumbar vertebrae for all. Conclusions: The variation of the number of tho racic or lumbar vertebrae was found in 9.2% juveniles and adolescents without spinal deformities, with a higher possibility of variable 11 thoracic or 6 lumbar vertebrae in Han population of Jiangsu.