【摘要】  揭示青少年胸椎特发性侧凸患者椎管内脊髓的偏移，明确其变化趋势，并探讨其可能的发生机制和临床意义。［方法］本研究包括39名以右胸弯为主弯的青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者。测量主胸弯节段内（T5~12）椎管内脊髓与凸凹侧椎弓根之间的距离，计算脊髓的偏移，揭示其变化趋势，并分析顶椎区脊髓偏移与主胸弯Cobbs角和顶椎相对偏移之间的相关性。［结果］在T5~12节段椎管内，脊髓与凸侧椎弓根之间的距离显著大于与凹侧椎弓根之间的距离（P＜0.05），即脊髓向凹侧椎弓根偏移，且以顶椎区最为显著，而逐渐向两侧端椎区递减。顶椎区脊髓偏移与主胸弯Cobbs角和顶椎相对偏移存在显著的正相关（相关系数分别为0.631和0.546）。［结论］胸椎特发性脊柱侧凸患者存在侧凸节段椎管内脊髓偏移的现象，且以顶椎区最显著。研究结果提示脊髓偏移可能与脊椎偏移后凹侧脊神经的牵拉有关，而且凹侧置钉的风险高于凸侧。

【关键词】  脊髓 偏移 青少年特发性脊柱侧凸 胸椎 椎弓根螺钉

    Abstract：［Objective］To demonstrate the shift of the spinal cord to the concave side of the spinal canal in adolescent patients with idiopathic thoracic scoliosis,to investigate possible cause of the shift of the spinal cord and to explore its clinical relevance.［Method］Thirtynine adolescents with idiopathic thoracic scoliosis were recruited in this study.Cobbs angle,relative apical translation and relative trunk shift of the major thoracic curves were recorded from standing posteroanterior roentgenography of the whole spine.The shift of the spinal cord was determined through the measurements of distance between the spinal cord and the m……