Adolesanlarda Omurganın Sagital Düzlem Dizilimi

Berivan Beril Kılıç; Hakan Akgül; Tuğba Kuru Çolak

doi:10.34087/cbusbed.751886

Araştırma Makalesi

Sagittal Plane Alignment of Spine in Adolescents

Yıl 2021, Cilt: 8 Sayı: 1, 23 - 28, 31.12.2020

Berivan Beril Kılıç Hakan Akgül Tuğba Kuru Çolak

https://doi.org/10.34087/cbusbed.751886

Öz

Objective: Changes in thoracal kyphosis and lumbar lordosis, which are physiological sagittal plane curvatures of the spine, may cause many problems for adolescents in the future. This study aimed to compare the sagittal plane parameters of the spine of adolescents who are sedentary, athletes and diagnosed as adolescent idiopathic scoliosis (AIS), by evaluating them and to prevent possible injuries that may arise from changes in these curvatures in the presence of abnormal curvature.
Materials and Methods: A total of 73 people (46 girls, 27 boys) who are 15-18 years old were included in the study. Of which, 27 were sedentary, 28 were athletes and 18 were individuals with adolescent idiopathic scoliosis (AIS). Gravity-dependent inclinometer (Baseline® Bubble® Inclinometer) was used to measure sagittal plane parameters. In addition, the Angle of Trunk Rotation (ATR) and Cobb angle values of the participants who were diagnosed as AIS were measured.
Results: The kyphosis angle in the scoliosis group was significantly lower than both groups (p <0.05). The lumbar lordosis angle values of the scoliosis group were significantly higher than the athletes’ group (p = 0.020). The mean ATR value of the scoliosis group was 9.67° and the Cobb value was 21.11°. When analyzed by gender, the thoracal kyphosis angle was significantly higher in boys and the lumbar lordosis angle was significantly higher in girls (respectively p=0.000; p = 0.003).
Conclusion: Our results showed that adolescents diagnosed with AIS have abnormal changes in physiological sagittal spinal parameters compared to sedentary and athletes; thoracal kyphosis angle was higher in boys and lumbar lordosis angle was higher in girls. Studies that also evaluated the spinopelvic complex, involving athletes with different sports branches and individuals with different curvature patterns are needed.

Anahtar Kelimeler

Adolescent idiopathic scoliosis, Lumbar lordosis, Thoracal kyphosis.

Kaynakça

1. Borges, P.A, Zelada, F, Dos Santos Barros, T.F, Letaif, O.B, da Rocha, I.D, Marcon, R.M, Cristante, A.F, Barros-Filho, T, A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis, Clinics (Sao Paulo, Brazil), 2017, 72(8), 481–484. https://doi.org/10.6061/clinics/2017(08)05.
2. Roussouly, P, Nnadi, C, Sagittal plane deformity: an overview of interpretation and management, Eur Spine J, 2010, 19(11), 1824‐1836. doi:10.1007/s00586-010-1476-9.
3. Grabara, M, Anteroposterior curvatures of the spine in adolescent athletes, Journal of back and musculoskeletal rehabilitation, 2014, 27(4), 513-519.
4. Ishikawa, Y, Miyakoshi, N, Hongo M, Kasukawa, Y, Kudo, D, Shimada, Y, Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls, Gait & Posture, 2017, 3(53), 98-103. doi: 10.1016/j.gaitpost.2017.01.011.
5. Aboutorabi, A, Arazpour, M, Ahmadi Bani, M, Keshtkar, A.A, (2018). Effect of spinal orthoses and postural taping on balance, gait and quality of life in older people with thoracic hyperkyphosis: protocol for a systematic review and meta-analysis, BMJ open, 2018, 8(1), e015813. https://doi.org/10.1136/bmjopen-2016-015813.
6. Kuo, Y.L, Chung, C.H, Huang, T.W, Tsao, C.H, Chang, S.Y, Peng, C.K, Cheng, W.E, Chien, W.C, Shen, C.H, Association between spinal curvature disorders and injury: a nationwide population-based retrospective cohort study, BMJ open, 2019, 9(1), e023604. https://doi.org/10.1136/bmjopen-2018-023604.
7. Ambegaonkar, J.P, Caswell, A.M, Kenworthy, K.L, Cortes, N, Caswell, S.V, Lumbar lordosis in female collegiate dancers and gymnasts, Medical problems of performing artists, 2014, 29(4), 189–192. https://doi.org/10.21091/mppa.2014.4039.
8. Puzovic, V, Rotim, K, Jurisic, V, Samardzic, M, Zivkovic, B, Savic, A, Rasulic, L, The Prevalence of Spine Deformities and Flat Feet among 10-12 Year Old Children Who Train Basketball--Cross-Sectional Study. Collegium antropologicum, 2015, 39(3), 625–629.
9. Sedrez, J.A, da Rosa, M.I, Noll, M, Medeiros, F, Candotti, C.T, Fatores de risco associados a alterações posturais estruturais da coluna vertebral em crianças e adolescentes [Risk factors associated with structural postural changes in the spinal column of children and adolescents]. Revista paulista de pediatria: orgao oficial da Sociedade de Pediatria de Sao Paulo, 2015, 33(1), 72–81. https://doi.org/10.1016/j.rpped.2014.11.012.
10. Betsch, M, Furian, T, Quack, V, Rath, B, Wild, M, Rapp, W, Effects of athletic training on the spinal curvature in child athletes. Research in sports medicine, 2015, 23(2), 190–202. https://doi.org/10.1080/15438627.2015.1005297.
11. Muyor, J.M, López-Miñarro, P.A, Alacid, F, A comparison of the thoracic spine in the sagittal plane between elite cyclists and non-athlete subjects. Journal of back and musculoskeletal rehabilitation, 2011, 24(3), 129–135. https://doi.org/10.3233/BMR-2011-0286.
12. Sullivan, T.B, Reighard, F.G, Osborn, E.J, Parvaresh, K.C, Newton, P.O, Thoracic Idiopathic Scoliosis Severity Is Highly Correlated with 3D Measures of Thoracic Kyphosis. J Bone Joint Surg Am. 2017, 99(11), e54. https://doi.org/10.2106/JBJS.16.01324.
13. Pizones, J, Núñez-Medina, A, Sánchez-Mariscal, F, Zúñiga, L, Izquierdo, E, Thoracic sagittal plane variations between patients with thoracic adolescent idiopathic scoliosis and healthy adolescents, Eur Spine J, 2016, 25(10), 3095‐3103. doi:10.1007/s00586-016-4400-0.
14. Newton, P.O, Osborn, E.J, Bastrom, T.P, Doan, J.D, Reighard, F.G, The 3D Sagittal Profile of Thoracic Versus Lumbar Major Curves in Adolescent Idiopathic Scoliosis, Spine deformity,2019,7(1),60–65. https://doi.org/10.1016/j.jspd.2018.05.003.
15. Salamh, P.A, Kolber, M, The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract, 2014, 30(1), 62‐67. doi:10.3109/09593985.2013.800174.
16. Hunter, D.J, Rivett, D.A, McKiernan, S, Weerasekara, I, Snodgrass, S.J, Is the inclinometer a valid measure of thoracic kyphosis? A cross-sectional study, Brazilian journal of physical therapy, 2018, 22(4), 310–317. https://doi.org/10.1016/j.bjpt.2018.02.005.
17. Amendt, L.E, Ause-Ellias, K.L, Eybers, J.L, Wadsworth, C.T, Nielsen, D.H, Weinstein, S.L, Validity and reliability testing of the Scoliometer, Physical therapy, 1990, 70(2), 108–117. https://doi.org/10.1093/ptj/70.2.108.
18. Coelho, D.M, Bonagamba, G.H, Oliveira, A.S, Scoliometer measurements of patients with idiopathic scoliosis, Brazilian journal of physical therapy, 2013, 17(2), 179–184. https://doi.org/10.1590/S1413-35552012005000081.
19. Patia Patias, P, Grivas, T.B, Kaspiris, A, Aggouris, C, Drakoutos, E, A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices. Scoliosis, 2010, 5, 12. https://doi.org/10.1186/1748-7161-5-12.
20. Abelin-Genevois, K, Sassi, D, Verdun, S, Roussouly, P, Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications, Eur Spine J, 2018, 27(9), 2192‐2202. doi:10.1007/s00586-018-5613-1.
21. Stokes I.A, Mechanical effects on skeletal growth. Journal of musculoskeletal & neuronal interactions, 2002, 2(3), 277–280.
22. Mac-Thiong, J.M, Labelle, H, Charlebois, M, Huot, M.P, de Guise, J.A. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type, Spine (Phila Pa 1976). 2003, 28(13), 1404‐1409. doi:10.1097/01.BRS.0000067118.60199.D1.
23. Yong, Q, Zhen, L, Zezhang, Z, Bangping, Q, Feng, Z, Tao, W, Jun, J, Xu, S, Xusheng, Q, Weiwei, M, Weijun, W, Comparison of sagittal spinopelvic alignment in Chinese adolescents with and without idiopathic thoracic scoliosis. Spine, 2012, 37(12), E714–E720. https://doi.org/10.1097/BRS.0b013e3182444402.
24. Moreira Pinto, E, Alves, J, de Castro, A.M, Silva, M, Miradouro, J, Teixeira, A, Miranda, A, High thoracic kyphosis: impact on total thoracic kyphosis and cervical alignment in patients with adolescent idiopathic scoliosis, Spine deformity, 2020, 10.1007/s43390-020-00069-6. Advance online publication. https://doi.org/10.1007/s43390-020-00069-6.
25. Propst-Proctor, S.L, Bleck, E.E, Radiographic determination of lordosis and kyphosis in normal and scoliotic children. J Pediatr Orthop, 1983, 3(3), 344‐346. doi:10.1097/01241398-198307000-00013.
26. Takács, M, Rudner, E, Kovács, A, Orlovits, Z, Kiss, R.M, The assessment of the spinal curvatures in the sagittal plane of children using an ultrasound-based motion analysing system. Annals of biomedical engineering, 2015, 43(2), 348–362. https://doi.org/10.1007/s10439-014-1160-z.
27. Gardner,A, Berryman,F, Pynsent, P, The development of Kyphosis and Lordosis in the Growing Spine, Spine, 2018, 43(19),e1109-e1115. https://doi.org/10.1097/BRS.0000000000002654.
28. Feng, Q, Jiang, C, Zhou, Y, Huang, Y, Zhang, M, Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study. Journal of back and musculoskeletal rehabilitation, 2017, 30(3), 625–633. https://doi.org/10.3233/BMR-160544.
29. Schlösser, T.P, van Stralen, M, Chu, W.C, Lm, T.P, Ng, B.K, Vincken, K.L, Cheng, J.C, Castelein, R.M, Anterior Overgrowth in Primary Curves, Compensatory Curves and Junctional Segments in Adolescent Idiopathic Scoliosis. PloS one, 2016, 11(7), e0160267. https://doi.org/10.1371/journal.pone.0160267.

Adolesanlarda Omurganın Sagital Düzlem Dizilimi

Yıl 2021, Cilt: 8 Sayı: 1, 23 - 28, 31.12.2020

Berivan Beril Kılıç Hakan Akgül Tuğba Kuru Çolak

https://doi.org/10.34087/cbusbed.751886

Öz

Giriş ve Amaç: Omurganın fizyolojik sagital düzlem eğriliklerinden olan torakal kifoz ve lumbal lordozdaki değişiklikler adolesanlarda ilerleyen dönemlerde bir çok soruna yol açabilir. Bu çalışmada amacımız; sedanter, sporcu ve skolyoz tanısı olan adolesanların omurgalarındaki sagital düzlem parametrelerini değerlendirerek birbirleriyle karşılaştırmak ve saptanan anormal eğrilik varlığında bu eğriliklerdeki değişikliklerden kaynaklanabilecek olası yaralanmaları önlemektir.
Gereç ve Yöntemler: Çalışmaya 15-18 yaş aralığında olan 27 sedanter, 28 sporcu ve 18 adolesan idiopatik skolyoz (AİS) tanısı alan genç birey olmak üzere toplam 73 kişi (46 kız, 27 erkek) katılmıştır. Sagital düzlem parametrelerinin ölçümü için yerçekimine bağlı inklinometre (Baseline® Bubble® Inclinometer) kullanılmıştır. Bunlara ek olarak skolyoz tanısı alan katılımcıların gövde rotasyon açısı (Angle of Trunk Rotation, ATR) ve Cobb açısı değerleri de ölçülmüştür
Bulgular: Skolyoz grubunda kifoz açısı her iki gruptan da anlamlı olarak daha az bulunmuştur(p<0,05). Skolyoz grubunun lumbal lordoz açı değerleri, sporcu grubundan anlamlı olarak daha fazla bulunmuştur (p=0,020). Skolyoz grubunun ortalama ATR değeri 9.67° ve Cobb değeri ise 21.11° idi. Cinsiyete göre incelendiğinde ise torakal kifoz açısı erkeklerde, lumbal lordoz açısı ise kızlarda anlamlı olarak daha yüksek bulunmuştur (sırasıyla p=0.000; p=0,003).
Sonuç: Sonuçlarımız AİS tanısı alan adolesanlarda sedanter ve sporcu gençlere göre fizyolojik sagital spinal parametrelerde anormal değişiklikler olduğunu; erkeklerde torakal kifoz açısının, kızlarda ise lumbal lordoz açısının daha fazla olduğunu göstermiştir. Spinopelvik kompleksin de değerlendirildiği, farklı spor branşıyla uğraşan sporcuların ve farklı eğrilik paternlerine sahip bireylerin de dahil edildiği çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Adolesan İdiopatik Skolyoz, torakal kifoz, lumbal lordoz

Kaynakça

1. Borges, P.A, Zelada, F, Dos Santos Barros, T.F, Letaif, O.B, da Rocha, I.D, Marcon, R.M, Cristante, A.F, Barros-Filho, T, A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis, Clinics (Sao Paulo, Brazil), 2017, 72(8), 481–484. https://doi.org/10.6061/clinics/2017(08)05.
2. Roussouly, P, Nnadi, C, Sagittal plane deformity: an overview of interpretation and management, Eur Spine J, 2010, 19(11), 1824‐1836. doi:10.1007/s00586-010-1476-9.
3. Grabara, M, Anteroposterior curvatures of the spine in adolescent athletes, Journal of back and musculoskeletal rehabilitation, 2014, 27(4), 513-519.
4. Ishikawa, Y, Miyakoshi, N, Hongo M, Kasukawa, Y, Kudo, D, Shimada, Y, Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls, Gait & Posture, 2017, 3(53), 98-103. doi: 10.1016/j.gaitpost.2017.01.011.
5. Aboutorabi, A, Arazpour, M, Ahmadi Bani, M, Keshtkar, A.A, (2018). Effect of spinal orthoses and postural taping on balance, gait and quality of life in older people with thoracic hyperkyphosis: protocol for a systematic review and meta-analysis, BMJ open, 2018, 8(1), e015813. https://doi.org/10.1136/bmjopen-2016-015813.
6. Kuo, Y.L, Chung, C.H, Huang, T.W, Tsao, C.H, Chang, S.Y, Peng, C.K, Cheng, W.E, Chien, W.C, Shen, C.H, Association between spinal curvature disorders and injury: a nationwide population-based retrospective cohort study, BMJ open, 2019, 9(1), e023604. https://doi.org/10.1136/bmjopen-2018-023604.
7. Ambegaonkar, J.P, Caswell, A.M, Kenworthy, K.L, Cortes, N, Caswell, S.V, Lumbar lordosis in female collegiate dancers and gymnasts, Medical problems of performing artists, 2014, 29(4), 189–192. https://doi.org/10.21091/mppa.2014.4039.
8. Puzovic, V, Rotim, K, Jurisic, V, Samardzic, M, Zivkovic, B, Savic, A, Rasulic, L, The Prevalence of Spine Deformities and Flat Feet among 10-12 Year Old Children Who Train Basketball--Cross-Sectional Study. Collegium antropologicum, 2015, 39(3), 625–629.
9. Sedrez, J.A, da Rosa, M.I, Noll, M, Medeiros, F, Candotti, C.T, Fatores de risco associados a alterações posturais estruturais da coluna vertebral em crianças e adolescentes [Risk factors associated with structural postural changes in the spinal column of children and adolescents]. Revista paulista de pediatria: orgao oficial da Sociedade de Pediatria de Sao Paulo, 2015, 33(1), 72–81. https://doi.org/10.1016/j.rpped.2014.11.012.
10. Betsch, M, Furian, T, Quack, V, Rath, B, Wild, M, Rapp, W, Effects of athletic training on the spinal curvature in child athletes. Research in sports medicine, 2015, 23(2), 190–202. https://doi.org/10.1080/15438627.2015.1005297.
11. Muyor, J.M, López-Miñarro, P.A, Alacid, F, A comparison of the thoracic spine in the sagittal plane between elite cyclists and non-athlete subjects. Journal of back and musculoskeletal rehabilitation, 2011, 24(3), 129–135. https://doi.org/10.3233/BMR-2011-0286.
12. Sullivan, T.B, Reighard, F.G, Osborn, E.J, Parvaresh, K.C, Newton, P.O, Thoracic Idiopathic Scoliosis Severity Is Highly Correlated with 3D Measures of Thoracic Kyphosis. J Bone Joint Surg Am. 2017, 99(11), e54. https://doi.org/10.2106/JBJS.16.01324.
13. Pizones, J, Núñez-Medina, A, Sánchez-Mariscal, F, Zúñiga, L, Izquierdo, E, Thoracic sagittal plane variations between patients with thoracic adolescent idiopathic scoliosis and healthy adolescents, Eur Spine J, 2016, 25(10), 3095‐3103. doi:10.1007/s00586-016-4400-0.
14. Newton, P.O, Osborn, E.J, Bastrom, T.P, Doan, J.D, Reighard, F.G, The 3D Sagittal Profile of Thoracic Versus Lumbar Major Curves in Adolescent Idiopathic Scoliosis, Spine deformity,2019,7(1),60–65. https://doi.org/10.1016/j.jspd.2018.05.003.
15. Salamh, P.A, Kolber, M, The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract, 2014, 30(1), 62‐67. doi:10.3109/09593985.2013.800174.
16. Hunter, D.J, Rivett, D.A, McKiernan, S, Weerasekara, I, Snodgrass, S.J, Is the inclinometer a valid measure of thoracic kyphosis? A cross-sectional study, Brazilian journal of physical therapy, 2018, 22(4), 310–317. https://doi.org/10.1016/j.bjpt.2018.02.005.
17. Amendt, L.E, Ause-Ellias, K.L, Eybers, J.L, Wadsworth, C.T, Nielsen, D.H, Weinstein, S.L, Validity and reliability testing of the Scoliometer, Physical therapy, 1990, 70(2), 108–117. https://doi.org/10.1093/ptj/70.2.108.
18. Coelho, D.M, Bonagamba, G.H, Oliveira, A.S, Scoliometer measurements of patients with idiopathic scoliosis, Brazilian journal of physical therapy, 2013, 17(2), 179–184. https://doi.org/10.1590/S1413-35552012005000081.
19. Patia Patias, P, Grivas, T.B, Kaspiris, A, Aggouris, C, Drakoutos, E, A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices. Scoliosis, 2010, 5, 12. https://doi.org/10.1186/1748-7161-5-12.
20. Abelin-Genevois, K, Sassi, D, Verdun, S, Roussouly, P, Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications, Eur Spine J, 2018, 27(9), 2192‐2202. doi:10.1007/s00586-018-5613-1.
21. Stokes I.A, Mechanical effects on skeletal growth. Journal of musculoskeletal & neuronal interactions, 2002, 2(3), 277–280.
22. Mac-Thiong, J.M, Labelle, H, Charlebois, M, Huot, M.P, de Guise, J.A. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type, Spine (Phila Pa 1976). 2003, 28(13), 1404‐1409. doi:10.1097/01.BRS.0000067118.60199.D1.
23. Yong, Q, Zhen, L, Zezhang, Z, Bangping, Q, Feng, Z, Tao, W, Jun, J, Xu, S, Xusheng, Q, Weiwei, M, Weijun, W, Comparison of sagittal spinopelvic alignment in Chinese adolescents with and without idiopathic thoracic scoliosis. Spine, 2012, 37(12), E714–E720. https://doi.org/10.1097/BRS.0b013e3182444402.
24. Moreira Pinto, E, Alves, J, de Castro, A.M, Silva, M, Miradouro, J, Teixeira, A, Miranda, A, High thoracic kyphosis: impact on total thoracic kyphosis and cervical alignment in patients with adolescent idiopathic scoliosis, Spine deformity, 2020, 10.1007/s43390-020-00069-6. Advance online publication. https://doi.org/10.1007/s43390-020-00069-6.
25. Propst-Proctor, S.L, Bleck, E.E, Radiographic determination of lordosis and kyphosis in normal and scoliotic children. J Pediatr Orthop, 1983, 3(3), 344‐346. doi:10.1097/01241398-198307000-00013.
26. Takács, M, Rudner, E, Kovács, A, Orlovits, Z, Kiss, R.M, The assessment of the spinal curvatures in the sagittal plane of children using an ultrasound-based motion analysing system. Annals of biomedical engineering, 2015, 43(2), 348–362. https://doi.org/10.1007/s10439-014-1160-z.
27. Gardner,A, Berryman,F, Pynsent, P, The development of Kyphosis and Lordosis in the Growing Spine, Spine, 2018, 43(19),e1109-e1115. https://doi.org/10.1097/BRS.0000000000002654.
28. Feng, Q, Jiang, C, Zhou, Y, Huang, Y, Zhang, M, Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study. Journal of back and musculoskeletal rehabilitation, 2017, 30(3), 625–633. https://doi.org/10.3233/BMR-160544.
29. Schlösser, T.P, van Stralen, M, Chu, W.C, Lm, T.P, Ng, B.K, Vincken, K.L, Cheng, J.C, Castelein, R.M, Anterior Overgrowth in Primary Curves, Compensatory Curves and Junctional Segments in Adolescent Idiopathic Scoliosis. PloS one, 2016, 11(7), e0160267. https://doi.org/10.1371/journal.pone.0160267.

Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Sağlık Kurumları Yönetimi
Bölüm	Araştırma Makalesi
Yazarlar	Berivan Beril Kılıç 0000-0002-5588-4371 Hakan Akgül 0000-0002-3877-260X Tuğba Kuru Çolak 0000-0002-3263-2278
Yayımlanma Tarihi	31 Aralık 2020
Yayımlandığı Sayı	Yıl 2021 Cilt: 8 Sayı: 1

Kaynak Göster

APA	Kılıç, B. B., Akgül, H., & Kuru Çolak, T. (2020). Adolesanlarda Omurganın Sagital Düzlem Dizilimi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 8(1), 23-28. https://doi.org/10.34087/cbusbed.751886
AMA	Kılıç BB, Akgül H, Kuru Çolak T. Adolesanlarda Omurganın Sagital Düzlem Dizilimi. CBU-SBED. Aralık 2020;8(1):23-28. doi:10.34087/cbusbed.751886
Chicago	Kılıç, Berivan Beril, Hakan Akgül, ve Tuğba Kuru Çolak. “Adolesanlarda Omurganın Sagital Düzlem Dizilimi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8, sy. 1 (Aralık 2020): 23-28. https://doi.org/10.34087/cbusbed.751886.
EndNote	Kılıç BB, Akgül H, Kuru Çolak T (01 Aralık 2020) Adolesanlarda Omurganın Sagital Düzlem Dizilimi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8 1 23–28.
IEEE	B. B. Kılıç, H. Akgül, ve T. Kuru Çolak, “Adolesanlarda Omurganın Sagital Düzlem Dizilimi”, CBU-SBED, c. 8, sy. 1, ss. 23–28, 2020, doi: 10.34087/cbusbed.751886.
ISNAD	Kılıç, Berivan Beril vd. “Adolesanlarda Omurganın Sagital Düzlem Dizilimi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8/1 (Aralık 2020), 23-28. https://doi.org/10.34087/cbusbed.751886.
JAMA	Kılıç BB, Akgül H, Kuru Çolak T. Adolesanlarda Omurganın Sagital Düzlem Dizilimi. CBU-SBED. 2020;8:23–28.
MLA	Kılıç, Berivan Beril vd. “Adolesanlarda Omurganın Sagital Düzlem Dizilimi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 8, sy. 1, 2020, ss. 23-28, doi:10.34087/cbusbed.751886.
Vancouver	Kılıç BB, Akgül H, Kuru Çolak T. Adolesanlarda Omurganın Sagital Düzlem Dizilimi. CBU-SBED. 2020;8(1):23-8.

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