| 摘要: |
| 目的 探讨退变性腰椎滑脱患者脊柱-骨盆矢状位参数特征及这些参数与腰椎滑脱的关系。方法 选择2016年6月至2018年6月我院收治的42例退变性腰椎滑脱患者（退变性腰椎滑脱组）和58例无滑脱的退变性腰椎疾病患者（对照组）作为研究对象。收集两组研究对象的一般资料，在脊柱全长正侧位X线片上测量骨盆倾斜角（PT）、骨盆投射角（PI）、骶骨倾斜角（SS）、腰椎前凸角（LL）、胸腰椎后凸角（TLK）、胸椎后凸角（TK）、矢状面躯干偏移（SVA）等矢状位参数，比较两组研究对象一般资料和矢状位参数的差异。以腰椎滑脱率为因变量，脊柱-骨盆矢状位参数为自变量，采用logistic回归模型分析腰椎滑脱程度的危险因素。结果 两组研究对象年龄、性别、身高、体质量差异均无统计学意义（P均>0.05）。退变性腰椎滑脱组和对照组患者PT、PI、SS、LL、TLK、SVA差异均有统计学意义（P均<0.05），而两组间TK差异无统计学意义（P>0.05）。对退变性腰椎滑脱组进行logistic回归分析，发现LL、PT是影响腰椎滑脱程度的危险因素（P均<0.05）。结论 退变性腰椎滑脱患者矢状位参数PT、PI、SS、LL、TLK、SVA明显改变，LL、PT是影响腰椎滑脱程度的危险因素。 |
| 关键词: 退变性腰椎滑脱 脊柱-骨盆参数 滑脱率 脊柱矢状位平衡 |
| DOI：10.16781/j.0258-879x.2019.04.0381 |
| 投稿时间：2019-02-18修订日期：2019-03-21 |
| 基金项目: |
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| Analysis of spinopelvic sagittal parameters in degenerative lumbar spondylolisthesis |
| HU Wen△,ZHAO Jian△,LI Bo,ZHOU Xiao-yi,ZHAI Xiao,ZHAO Ying-chuan,CHEN Zi-qiang,LI Ming* |
(Department of Spine Surgery, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the characteristics of spinopelvic sagittal parameters in degenerative lumbar spondylolisthesis patients and the relationship between these parameters and lumbar spondylolisthesis. Methods From Jun. 2016 to Jun. 2018, 42 patients with degenerative lumbar spondylolisthesis (DLS) were enrolled in study group, and 58 degenerative lumbar disease patients without spondylolisthesis were enrolled in control group. The general characteristics of the patients were collected. The sagittal parameters, including pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL) and sagittal vertical axis (SVA), were measured on lateral X-ray films of full-length spine. The differences of general characteristics and sagittal parameters were compared between the two groups. With the lumbar spondylolisthesis rate as dependent variable and the spinopelvic sagittal parameter as independent variable, logistic regression model was used to analyze the risk factors of lumbar spondylolisthesis. Results There were no significant differences in the age, gender, height or body mass of the patients between the two groups (all P>0.05). There were significant differences in the PT, PI, SS, LL, TLK and SVA between the DLS group and the control group (all P<0.05), but there was no significant difference in the TK (P>0.05). Logistic regression analysis showed that LL and PT were risk factors of lumbar spondylolisthesis (both P<0.05). Conclusion The sagittal parameters (PT, PI, SS, LL, TLK and SVA) in the patients with DLS are significantly changed. LL and PT are the risk factors of lumbar spondylolisthesis. |
| Key words: degenerative lumbar spondylolisthesis spinopelvic parameters spondylolisthesis rate sagittal balance of spine |
