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慢性腰痛患者脊柱-骨盆矢状面参数特征分析
林秋水1△,牛升波1,2△,李博1,黄泽彬1,石志才1,杨长伟1*
0
(1. 海军军医大学(第二军医大学)第一附属医院脊柱外科, 上海 200433;
2. 解放军陆军第八十三集团军医院骨科, 新乡 453004
共同第一作者
*通信作者)
摘要:
目的 探讨慢性腰痛患者脊柱-骨盆矢状面参数特征及其与慢性腰痛的关系。方法 选择2019年7月至2021年6月在海军军医大学(第二军医大学)第一附属医院门诊就诊的249例慢性腰痛患者(腰痛组)和同期于该院体检的86例无腰痛症状成人(对照组)作为研究对象。收集两组研究对象的一般资料,在全脊柱正侧位X线片上测量胸椎后凸角(TK)、腰椎前凸角(LL)、LL-TK、骶骨倾斜角(SS)、骨盆倾斜角(PT)、骨盆入射角(PI)、SS-PT、LL-PI、矢状面躯干偏移(SVA)等矢状面参数,比较两组研究对象一般资料和矢状面参数的差异。结果 两组研究对象的年龄、性别、BMI差异均无统计学意义(P均>0.05)。腰痛组的TK大于对照组,而LL-TK、SS、PI和SS-PT均小于对照组(P均<0.05),两组间LL、PT、LL-PI和SVA差异均无统计学意义(P均>0.05)。腰痛组与对照组的腰椎前凸类型均以2型(SS<35°、LL较小、腰椎前凸顶点位于L4)为主,分别占70.7%(176/249)和57.0%(49/86),两组的腰椎前凸类型构成比差异无统计学意义(χ2=6.161,P=0.104)。结论 慢性腰痛患者的脊柱-骨盆矢状面参数与无腰痛症状的成年人不同,慢性腰痛患者的多见大TK、小SS、小PI,提示这一特定模式与慢性腰痛的存在有关。
关键词:  慢性腰痛  骨盆形态  矢状面平衡  脊柱-骨盆参数
DOI:10.16781/j.CN31-2187/R.20220822
投稿时间:2022-10-24修订日期:2022-12-22
基金项目:海军军医大学(第二军医大学)第一附属医院“234学科攀峰计划”(2020YXK040).
Characteristics of sagittal spino-pelvic parameters in patients with chronic low back pain
LIN Qiu-shui1△,NIU Sheng-bo1,2△,LI Bo1,HUANG Ze-bin1,SHI Zhi-cai1,YANG Chang-wei1*
(1. Department of Spinal Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Orthopaedics, No. 83 Army Group Hospital, Xinxiang 453004, Henan, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To explore the characteristics of sagittal spino-pelvic parameters in patients with chronic low back pain and their relationship with chronic low back pain. Methods From Jul. 2019 to Jun. 2021, 249 patients with chronic low back pain (LBP group) and 86 physical examination adults without low back pain symptoms (control group) were selected as subjects in The First Affiliated Hospital of Naval Medical University (Second Military Medical University). The general data of the 2 groups were collected, the thoracic kyphosis (TK), lumbar lordosis (LL), LL-TK, sacral inclination (SS), pelvic inclination (PT), pelvic incidence (PI), SS-PT, LL-PI, sagittal verticalaxis (SVA) and other sagittal parameters were measured on the full-length anteroposterior and lateral X-ray films of the spine, and the differences between the 2 groups were observed. Results There were no significant differences in age, gender or body mass index between the 2 groups (all P>0.05). TK in the LBP group was higher than that in the control group, while LL-TK, SS, PI and SS-PT in the LBP group were lower than those in the control group (all P<0.05). There were no significant differences in LL, PT, LL-PI or SVA between the 2 groups (all P>0.05). The types of lordosis were mainly type 2 (SS<35°, small LL, the apex of lumbar lordosis is located in L4) in the LBP group and control group, accounting for 70.7% (176/249) and 57.0% (49/86), respectively. There was no significant difference in the composition ratio of lordosis types between the 2 groups (χ2=6.161, P=0.104). Conclusion The sagittal spino-pelvis parameters of patients with chronic low back pain are different from those of adults without low back pain symptoms. Large TK, small SS, and small PI are more common in the low back pain patients, suggesting that this particular pattern is related to chronic low back pain.
Key words:  chronic low back pain  pelvic morphology  sagittal balance  spino-pelvic parameters