腰椎退变性后凸截骨矫形内固定后矢状面的平衡变化  

Changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis

作　　者：任周梁 朱松青[2] 梁卫东[1] 盛伟斌[1] 盛军[1] 

机构地区：[1]新疆医科大学第一附属医院脊柱外科,新疆维吾尔自治区乌鲁木齐市830054 [2]新疆医科大学第六附属医院脊柱外科,新疆维吾尔自治区乌鲁木齐市830002

出　　处：《中国组织工程研究》2016年第4期564-570,共7页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金资助项目(2014211C026)~~

摘　　要：背景:目前,脊柱-骨盆矢状面平衡对患者生活质量的影响越来越受到学者们的重视。而腰椎退变性后凸畸形矫正后脊柱影像学参数的变化未见报道。目的:探讨腰椎退变性后凸畸形患者截骨矫形后脊柱矢状面平衡的变化。方法:回顾性分析2012年2月至2014年12月于新疆医科大学第一附属医院接受截骨矫形内固定的35例腰椎退变性后凸畸形患者资料,测量患者内固定前、内固定后即刻及末次随访时的影像学参数。结果与结论:(1)所有患者内固定后除骨盆入射角外,其余参数与内固定前相比差异有显著性意义(P<0.05)。(2)末次随访时除后凸Cobb角、骨盆入射角、胸椎后凸角和胸腰段后凸角外,其余参数分别与内固定后相比差异有显著性意义(P<0.05)。(3)内固定后骨盆倾斜角的变化值与腰椎前凸角的变化值之间呈负相关(r=-0.610,P<0.001),胸椎后凸角的变化值与腰椎前凸角的变化值呈正相关(r=0.598,P<0.001)。(4)结果提示腰椎退变性后凸畸形截骨矫形内固定后腰椎矢状面形态得到显著改善,同时邻近的胸椎和骨盆会发生明显变化,以适应新的矢状面平衡。BACKGROUND： At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters following corrective osteotomy for lumbar degenerative kyphosis have not been reported. OBJECTIVE： To evaluate postoperative changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis. METHODS： We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final follow-up. RESULTS AND CONCLUSION：（1） There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle（P〈0.05）.（2） There were significant differences between postoperative and last follow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis（P〈0.05）.（3） Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation（r=-0.610, P 〈0.001）. Thoracic kyphosis was positively correlated with lumbar lordosis（r=0.598, P 〈0.001）.（4） Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.

关 键 词：腰椎 骨盆 截骨术 组织工程 骨科植入物 脊柱植入物 腰椎后凸 截骨 矢状面平衡 脊柱后凸 矫形 腰椎后凸角 胸椎后凸角 骨盆倾斜角 新疆维吾尔自治区自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]