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| 脊柱骨盆矢状面参数随年龄的变化 |
| 李博,胡文,杨明园,周潇逸,翟骁,魏显招,杨长伟*,李明* |
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(海军军医大学(第二军医大学)长海医院骨科, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 研究中国东部地区不同年龄阶段脊柱骨盆矢状面参数的差异及随年龄如何变化。方法 回顾性分析2014年1月至2015年8月于我院健康体检中心留存的311名无症状健康志愿者的资料，由2名外科医师收集人口统计学数据及脊柱骨盆矢状面影像学参数，包括年龄、性别、最大胸椎后凸角、最大腰椎前凸角、最大腰椎前凸角-最大胸椎后凸角、骶骨倾斜角、骨盆倾斜角、骨盆入射角、骨盆倾斜角与骶骨倾斜角比值、骨盆入射角-腰椎前凸角、矢状面躯干偏移、T1矢状面角度、T1骨盆角度及T1脊柱骨盆倾斜角。采用Pearson相关分析研究年龄与矢状面参数的关系，建立多元线性回归方程分析年龄与最大胸椎后凸角的关系。根据年龄将研究对象分为7组：<20岁、≥ 20且<30岁、≥ 30且<40岁、≥ 40且<50岁、≥ 50且<60岁、≥ 60且<70岁和≥ 70岁，采用Kruskal-Wallis H检验比较各年龄段脊柱骨盆矢状面参数的差异。结果 311名健康志愿者的最大胸椎后凸角（r=0.280，P<0.01）、最大腰椎前凸角-最大胸椎后凸角（r=-0.320，P<0.01）、骶骨倾斜角（r=-0.216，P<0.01）、骨盆倾斜角（r=0.237，P<0.01）、骨盆倾斜角与骶骨倾斜角比值（r=0.282，P<0.01）、矢状面躯干偏移（r=0.279，P<0.01）、T1矢状面角度（r=0.247，P<0.01）及T1骨盆角度（r=0.259，P<0.01）均与年龄相关，而最大腰椎前凸角、骨盆入射角、骨盆入射角-腰椎前凸角及T1脊柱骨盆倾斜角均与年龄无明显相关性（P均>0.05）。建立多元线性回归方程：最大胸椎后凸角=0.175×年龄+28.233，年龄每增长10岁最大胸椎后凸角增加1.75°。<20岁、≥ 20且<30岁、≥ 30且<40岁、≥ 40且<50岁、≥ 50且<60岁、≥ 60且<70岁和≥ 70岁组人数分别为8、56、51、59、56、56、25名，最大胸椎后凸角、骨盆倾斜角、骨盆倾斜角与骶骨倾斜角比值、矢状面躯干偏移、T1矢状面角度及T1骨盆角度均随年龄增长而增大（P均<0.01），最大腰椎前凸角-最大胸椎后凸角、骶骨倾斜角则随年龄增长而减小（P<0.01、P<0.05）。结论 在中国东部地区无症状健康志愿者中，最大胸椎后凸角随年龄增长而增大（年龄每增长10岁最大胸椎后凸角增大1.75°）。 |
| 关键词: 矢状面参数 脊柱 骨盆 年龄 矢状面平衡 |
| DOI：10.16781/j.0258-879x.2020.03.0254 |
| 投稿时间：2019-05-14修订日期：2019-06-26 |
| 基金项目:国家自然科学基金（81372012）. |
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| Changes of sagittal spino-pelvic parameters with age |
| LI Bo,HU Wen,YANG Ming-yuan,ZHOU Xiao-yi,ZHAI Xiao,WEI Xian-zhao,YANG Chang-wei*,LI Ming* |
(Department of Orthopaedics, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding authors) |
| Abstract: |
| Objective To explore the difference of sagittal spino-pelvic parameters at different age stages and the changes with age in Eastern China. Methods The medical records of 311 asymptomatic healthy volunteers from Jan. 2014 to Aug. 2015 in Physical Examination Center of our hospital were retrospectively analyzed. The demographic data and radiological parameters were collected by two individual surgeons, including age, gender, maximum thoracic kyphosis (maxTK), maximum lumbar lordosis (maxLL), maxLL minus maxTK (maxLL-maxTK), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), PT/SS, PI minus lumbar lordosis (PI-LL), sagittal vertical axis (SVA), T1 sagittal angle, T1 pelvic angle (TPA) and T1 spinopelvic inclination (T1SPI). Pearson correlation analysis was performed to evaluate the relationship between age and sagittal spino-pelvic parameters. A multiple linear regression equation was established to analyze the relationship between age and maxTK. The volunteers were divided into seven groups (<20 years, ≥ 20 and <30 years, ≥ 30 and <40 years, ≥ 40 and <50 years, ≥ 50 and <60 years, ≥ 60 and <70 years, and ≥ 70 years), and the sagittal spino-pelvic parameters were compared using Kruskal-Wallis H test. Results In 311 healthy volunteers, the maxTK (r=0.280, P<0.01), maxLL-maxTK (r=-0.320, P<0.01), SS (r=-0.216, P<0.01), PT (r=0.237, P<0.01), PT/SS (r=0.282, P<0.01), SVA (r=0.279, P<0.01), T 1 sagittal angle (r=0.247, P<0.01) and TPA (r=0.259, P<0.01) were all related to age, while the maxLL, PI, PI-LL, and T1SPI were not related to age (all P>0.05). According to the established multiple linear regression equation:maxTK=0.175×age+28.233, the maxTK increased by 1.75° every 10 years of age. There were 8, 56, 51, 59, 56, 56 and 25 volunteers in the groups of <20 years, ≥ 20 and <30 years, ≥ 30 and <40 years, ≥ 40 and <50 years, ≥ 50 and <60 years, ≥ 60 and <70 years, and ≥ 70 years, respectively. The maxTK, PT, PT/SS, SVA, T1 sagittal angle and TPA were significantly increased with age (all P<0.01), and the maxLL-maxTK and SS were significantly decreased with age (P<0.01, P<0.05). Conclusion In asymptomatic population of Eastern China, maxTK is increased with age (1.75° per 10 years old). |
| Key words: sagittal parameters spine pelvis age sagittal balance |
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