腰痛的髋关节骨关节炎患者腰椎-骨盆矢状位参数的研究  

Study on the lumbar-pelvic sagittal parameters in patients with hip osteoarthritis with low back pain

作　　者：刘步云[1] 沈海[1] 吴忌[1] 胡松 王泉巅[1] 史梦龙[1] 孙育良 LIU Bu-yun;SHEN Hai;WU Ji;HU Song;WANG Quan-dian;SHI Meng-long;SUN Yu-liang(Orthopedics Hospital of Sichuan Province,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《颈腰痛杂志》2022年第3期348-351,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：四川省卫健委项目(编号:17PJ423)。

摘　　要：目的探讨髋关节骨关节炎(hip osteoarthritis,HOA)对腰椎-骨盆矢状位参数的影响及与腰痛的关系。方法回顾性分析2018年1月~2019年12月本院收治的60例HOA患者作为HOA组,选取同期50例正常成人作为对照组。测量两组研究对象的腰椎前凸角(lumbar lordosis,LL)、骨盆投射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)。根据是否伴有腰痛,将HOA组再分为腰痛组、无腰痛组。比较两组间、两亚组间及两亚组与对照组间腰椎-骨盆矢状位参数的差异。分析HOA组各参数与腰部VAS评分之间的相关性。结果两组间比较,HOA组LL小于对照组(P<0.05);两组间PI、PT、SS差异无统计学意义(P>0.05)。HOA患者腰痛组的LL、SS小于无腰痛组(P<0.05),PT大于无腰痛组(P<0.05);两亚组间PI比较差异无统计学意义(P>0.05)。腰痛组与对照组比较,腰痛组LL小于对照组(P<0.05);两组间PI、PT、SS差异无统计学意义(P>0.05)。无腰痛组与对照组比较,LL、PI无明显统计学差异(P>0.05);无腰痛组PT小于对照组,而SS大于对照组(P<0.05)。相关性分析显示,腰部VAS评分与LL、PI、SS之间存负相关性,与PT存在正相关性(P<0.05)。结论腰痛的HOA患者腰椎前凸减小,腰椎-骨盆矢状位失平衡。腰椎-骨盆矢状位形态改变可能是导致HOA患者腰痛的原因。Objective To explore the influence of hip osteoarthritis(HOA)on the parameters of the lumbar spine-pelvic sagittal position and its relationship with low back pain.Methods From January 2018 to December 2019,60 HOA patients were selected as the HOA group,and 50 normal adults during the same period were selected as the control group.The clinical data were retrospectively analyzed.The lumbar lordosis(LL),pelvic incidence(PI),pelvic tilt(PT),and sacral slope(SS)of the two groups were measured.According to whether the patients were accompanied by low back pain,the HOA group was divided into low back pain group and no low back pain group.The differences in the sagittal parameters of the lumbar spine and pelvis were compared between the two groups,between the two subgroups,and between the two subgroups and the control group.The correlation between the parameters of the HOA group and the waist VAS score was analyzed.Results The LL of the HOA group was smaller than that of the control group(P<0.05),there were no significant differences in PI,PT and SS between the two groups(P>0.05).The LL,SS of HOA patients with low back pain group were lower than those of no back pain group(P<0.05),and PT of the low back pain group was greater than that of the no back pain group(P<0.05),there was no significant difference in PI between the two groups(P>0.05).Compared with the control group,the LL of the low back pain group was lower(P<0.05),there were no significant differences in PI,PT,SS between the two groups(P>0.05).There were no significant differences in LL and PI between the no back pain group and the control group(P>0.05).The PT of the no back pain group was lower than that of the control group(P<0.05),while the SS was greater than the control group(P<0.05).Correlation analysis showed that there was a negative correlation between the waist VAS score and LL,PI,SS,and a positive correlation with PT(P<0.05).Conclusion HOA patients with low back pain have reduced lumbar lordosis,and lumbar-pelvic sagittal imbalance.The sagittal morph

关 键 词：腰痛 髋关节 骨关节炎 腰椎-骨盆参数 

分 类 号：R441.1[医药卫生—诊断学]