发育性髋关节发育不良患者髋臼发育程度与脊柱-骨盆参数的相关性  

Correlation between acetabular development and spinopelvic parameters in patients with developmental dysplasia of the hip

作　　者：林天烨 张文胜 何晓铭 何敏聪 李子祺 陈镇秋[3] 张庆文 何伟 魏秋实 Lin Tianye;Zhang Wensheng;He Xiaoming;He Mincong;Li Ziqi;Chen Zhenqiu;Zhang Qingwen;He Wei;Wei Qiushi(Guangdong Institute of Traditional Chinese Medicine Bone Trauma,Guangzhou 510405,Guangdong Province,China;Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]广东省中医骨伤研究院,广东省广州市510405 [2]广州中医药大学第三附属医院,广东省广州市510405 [3]广州中医药大学第一附属医院,广东省广州市510000

出　　处：《中国组织工程研究》2024年第6期857-861,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金面上项目(82274544),项目负责人:魏秋实;广东省中医药管理局项目(20223012),项目负责人:张庆文;广东省中医骨伤研究院开发课题(GYY202102-03),项目负责人:张庆文;广州中医药大学第三附属医院科研创新基金课题(Sy2022002),项目负责人:林天烨。

摘　　要：背景:在发育性髋关节发育不良的相关研究中,大部分集中于髋关节畸形,目前缺乏髋臼发育不良对脊柱影响的报道。目的:探讨发育性髋关节发育不良患者冠状位及矢状位脊柱-骨盆参数代偿情况,并探讨髋臼发育程度与脊柱-骨盆参数的相关性。方法:选择2018年1月至2022年6月于广州中医药大学第三附属医院就诊的发育性髋关节发育不良患者101例(试验组),选择同期健康体检者114例(对照组),两组均拍摄冠状位及矢状位脊柱全长X射线片,获取以下脊柱-骨盆参数:腰椎前凸角、骨盆前倾角、胸腰椎后凸角、Cobb角及C_(7)铅垂线与骶骨中垂线的距离、骶骨倾斜角、骨盆入射角、胸椎后凸角,对比两组受试对象脊柱-骨盆参数差异;另外,对比单侧、双侧以及不同Crowe分型发育性髋关节发育不良患者的脊柱-骨盆参数差异,采用Pearson相关分析探讨髋臼发育程度(Sharp角)与脊柱-骨盆参数的相关性。结果与结论:(1)在矢状位上,试验组腰椎前凸角小于对照组(P<0.05),骨盆倾斜角、胸腰段后凸角大于对照组(P<0.05);在冠状位上,试验组Cobb角、C_(7)铅垂线与骶骨中垂线的距离大于对照组(P<0.05);两组间其余脊柱-骨盆参数测量值比较差异均无显著性意义(P>0.05);(2)双侧发育性髋关节发育不良患者的腰椎前凸角小于单侧发育性髋关节发育不良患者(P<0.05),骨盆倾斜角、胸腰段后凸角、Cobb角及C_(7)铅垂线与骶骨中垂线的距离均大于单侧发育性髋关节发育不良患者(P<0.05);(3)腰椎前凸角随着Crowe分型严重程度的增加而减少(P<0.05),骨盆倾斜角随着Crowe分型严重程度的增加而增加(P<0.05);(4)Pearson相关分析显示,Sharp角与腰椎前凸角呈负相关(P<0.05),骨盆前倾角、Cobb角及C_(7)铅垂线与骶骨中垂线呈正相关(P<0.05);(5)结果显示,发育性髋关节发育不良患者的骨盆倾斜角、胸腰段后凸角、Cobb角及C_(7)铅垂线与骶骨�BACKGROUND:The majority of studies on developmental dysplasia of the hip focus on hip malformations,but there are few reports on the effects of acetabular dysplasia on the spine.OBJECTIVE:To investigate the compensation of spinopelvic parameters in coronal and sagittal views in patients with developmental dysplasia of the hip,and to explore the correlation between acetabular development and spinopelvic parameters.METHODS:A total of 101 patients with developmental dysplasia of the hip admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to June 2022 were selected as the trial group,and 114 healthy subjects were selected as the control group during the same period.The spinopelvic parameters of the subjects were measured through the full-length X-ray films of the coronal and sagittal spines:lumbar lordosis,anterior pelvic tilt,thoracolumbar kyphosis,Cobb angle,and the distance between the C_(7) plumb line and the center sacral vertical line,sacral slope,pelvic incidence,and thoracic kyphosis.The differences in spinopelvic parameters were compared between the two groups.In addition,the differences in spinopelvic parameters in patients with unilateral,bilateral and different Crowe classifications of developmental dysplasia of the hip were compared.Pearson correlation analysis was used to explore the correlation between Sharp angle and spinopelvic parameters.RESULTS AND CONCLUSION:(1)In the sagittal view,the lumbar lordosis in the trial group was significantly lower than that in the control group(P<0.05).The pelvic tilt and kyphosis angle of the thoracolumbar segment in the trial group were significantly greater than those in the control group(P<0.05).In the coronary position,the Cobb angle and the distance between the C_(7) plumb line and center sacral vertical line in the trial group were significantly greater than those in the control group(P<0.05).There was no significant difference in the remaining spinopelvic parameters between the two groups(P>0.05).(2)The lumba

关 键 词：髋臼发育程度 发育性髋关节发育不良 脊柱-骨盆参数 代偿 相关性 侧弯 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687