中老年人从站立位到坐位的脊柱矢状位序列变化  

The changes in sagittal alignment of spine from standing to sitting position in elderly people

作　　者：王伟[1,2] 周思宇 孙卓然 施集[1] 李危石 陈仲强[1] WANG Wei;ZHOU Siyu;SUN Zhuoran(Orthopaedic Department,Peking University Third Hospital,Beijing,100191,China)

机构地区：[1]北京大学第三医院骨科,北京市100191 [2]北京大学医学部,北京市100191

出　　处：《中国脊柱脊髓杂志》2019年第7期621-626,共6页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探究中老年人脊柱矢状位序列从站立位到坐位的变化,比较中老年人与青年人在体位改变时矢状位序列的变化差异.方法:回顾性分析在北京大学第三医院行健康检查的53例中老年人资料[男性17人,女性36人,年龄60.7±9.3(45~81)岁]和145例青年人资料[男性51人,女性94人,年龄23.1±2.3(19~29)岁].所有人均有站立位和坐位时的全脊柱X线检查结果,通过院内影像归档与通信(PACS)系统,测量骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、腰椎前凸角(LL)、胸椎后凸角(TK)、脊柱骶骨角(SSA)、腰椎倾斜角(LT)、脊柱矢状轴(SVA)、T1骨盆角(TPA)等参数.采用配对样本t检验比较中老年组站立位-坐位时矢状位序列的不同,通过独立样本t检验比较中老年组与青年组从站立位到坐位时矢状位序列变化.结果:中老年组站立位SVA为3.9±27.7mm,TPA为8.5°±6.9°,PT为12.7°±7.2°,SSA为124.3°±9.0°,LL为47.2°±12.1°,LT为-6.0°±6.9°,TK为33.2°±8.7°,SS为32.8°±8.2°,坐位时SVA为25.9±26.0mm,TPA为18.1°±8.5°,PT为21.1°±9.5°,SSA为113.6°±10.3°,LL为33.8°±12.9°,LT为-4.4°±5.7°,TK为28.5°±9.7°,SS为25.1°±9.2°,除LT外均存在统计学差异(P<0.05).站立位到坐位时,其SVA增加22.0±32.6mm,TPA增加9.6°±6.2°,PT增加8.4°±7.3°,LT增加1.5°±6.2°,LL减小13.4°±8.8°,TK减小4.6°±5.0°,SS减少7.6°±7.2°,SSA减小10.7°±8.1°,变化程度均小于青年组(P<0.05).结论:中老年人从站立位到坐位脊柱-骨盆矢状位形态表现为骨盆后倾,脊柱生理曲度变浅,矢状轴前移,脊柱-骨盆矢状位序列受体位影响变化程度明显小于青年人.Objectives:To explore how the sagittal alignment of spine change in elderly people from standing position to sitting position and compare these changes with that of normal young Chinese adults.Methods:The data of 53 elder persons(17 males,36 females;mean age,60.7±9.3 years)and 145 young adults(51 males,94 females;mean age,23.1±2.3 years)that underwent physical examination in Peking University Third Hospital were retrospective reviewed.All of them underwent the full-spine X-ray scan in standing and sitting position.Pelvic and spinal parameters were measured by Picture Archiving and Communication System,including pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),thoracic kyphosis(TK),spinosacral angle(SSA),lordosis tilt(LT),sagittal vertical axis(SVA)and T1-pelvic angle(T1PA).The parameters in different positions were compared using paired t test,and the changes from standing to sitting between elder persons and young adults were compared using independent t test.Results:For elder persons,SVA was 3.9±27.7mm in standing position.TPA,PT,SSA,LL,LT,TK and SS was 8.5°±6.9°,12.7°±7.2°,124.3°±9.0°,47.2°±12.1°,-6.0°±6.9°,33.2°±8.7°and 32.8°±8.2°,respectively.While in sitting position,SVA was 25.9±26.0mm,TPA,PT,SSA,LL,LT,TK and SS was 18.1°±8.5°,21.1°±9.5°,113.6°±10.3°,33.8°±12.9°,-4.4°±5.7°,28.5°±9.7°and 25.1°±9.2°,respectively.There were statistical differences(P<0.05)except LT.Changing from standing position to sitting position,SVA increased 22.0±32.6mm,TPA,PT and LT increased 9.6°±6.2°,8.4°±7.3°and 1.5°±6.2°,respectively;LL,TK,SS and SSA decreased 13.4°±8.8°,4.6°±5.0°,7.6°±7.2°and 10.7°±8.1°,respectively.Compared with the young adults,elder persons showed smaller increase in SVA,TPA,PT,LT and smaller decrease in LL,TK,SS when moving from standing to sitting position.Conclusions:When changing from standing position to sitting position,the spine of elder persons went forwards,accompanied with straighter sagittal curve,pelvic retrov

关 键 词：矢状位序列 坐位改变 中老年人 

分 类 号：R445.4[医药卫生—影像医学与核医学]