退变性与峡部裂性腰椎滑脱患者脊柱—骨盆矢状面参数的对比研究  

A comparative study of the difference in sagittal spine-pelvic parameters between lumbar degenerative and isthmic spondylolisthesis patients

作　　者：张权 刘磊 韩猛 刘光普 马超 ZHANG Quan;LIU Lei;HAN Meng;LIU Guangpu;MA Chao(Graduate School,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Xuzhou Clinical School,Xuzhou Medical University;Department of Spinal Surgery,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州医科大学徐州临床学院 [3]徐州市中心医院脊柱外科,江苏徐州221009

出　　处：《徐州医科大学学报》2023年第7期469-474,共6页Journal of Xuzhou Medical University

基　　金：徐州市科技创新专项(KC20129);徐州医科大学附属医院发展基金项目(XYFY2020019)。

摘　　要：目的探讨退变性腰椎滑脱与峡部裂性腰椎滑脱患者脊柱—骨盆矢状面参数的差异。方法选取2020年9月—2021年11月于徐州市中心医院就诊的退变性腰椎滑脱与峡部裂性腰椎滑症患者共80例,其中退变性腰椎滑脱患者设为退变组(n=37),峡部裂性腰椎滑脱患者设为峡部裂组(n=43),另取同期健康体检无症状者为对照组(n=48)。在站立位脊柱全长X线侧位片上测量以下脊柱骨盆参数:骨盆入射角(PI)、骶骨倾斜角(SS)、骨盆倾斜角(PT)、腰椎前凸角(LL)、胸椎后凸角(TK)、矢状面轴向垂直距离(SVA)、滑脱角(SA)、滑脱距离(SD)、滑脱百分率(SP)。将退变组、峡部裂组的相关数据与正常组进行比较,分析各组内SP与脊柱—骨盆各参数之间的相关性。结果峡部裂组的PI、PT、LL、TK大于正常组,差异有统计学意义(P<0.05)。退变组的PI、PT、SVA大于正常组,LL小于正常组,差异有统计学意义(P<0.05)。峡部裂组的LL、TK、SA大于退变组,SVA小于退变组,差异有统计学意义(P<0.05)。退变性腰椎滑脱组SP与PI、PT、SVA、SD呈显著相关。峡部裂性腰椎滑脱组SP与PI、LL、SD呈显著相关。结论PI较高可能是导致退变性和峡部裂性腰椎滑脱发生的诱发因素,而PT是退变性腰椎滑脱发生的预测因素,LL是峡部裂性腰椎滑脱发生的预测因素。Objective To investigate the difference in sagittal spine-pelvic parameters between lumbar degenerative and isthmic spondylolisthesis patients.Methods A total of 80 patients who were admitted to Xuzhou Central Hospital from September 2020 to November 2021 were enrolled,including 37 degenerative spondylolisthesis cases(a degeneration group)and 43 isthmic spondylolisthesis cases(an isthmi group).Meanwhile,48 healthy volunteers without related symptoms during physical examination were selected and set a normal group.The following spinal and pelvic parameters were measured on lateral radiographs of the full length of the spine in the standing position:pelvic incidence angle(PI),lumbosacral inclination angle(SS),pelvic inclination angle(PT),lumbar lordosis angle(LL),thoracic kyphosis angle(TK),sagittal vertical axis(SVA),slip angle(SA),slippage distance(SD)and slip percentage(SP).The three groups were compared for the parameters mentioned above,while the correlations between SP and the spine-pelvis parameters were analyzed.Results The isthmi group showed remarkably higher PI,PT,LL,and TK than the normal group(P<0.05).The degeneration group presented significant increases in PI,PT,and SVA,as well as decreases in LL,compared with the normal group(P<0.05).The isthmi group showed remarkably higher LL,SA,and TK,as well as lower SVA than the degeneration group(P<0.05).For the degeneration group,SP was significantly correlated with PI,PT,SVA,and SD.For the isthmi group,SP was significantly correlated with PI,LL,and SD.Conclusions Higher PI may be a predisposing factor for degenerative and isthmic spondylolisthesis.PT is one of the predictive factors for degenerative spondylolisthesis,whereas LL is one of the predictive factors for isthmic spondylolisthesis.

关 键 词：峡部裂性腰椎滑脱 退变性腰椎滑脱 脊柱—骨盆参数 骨盆入射角 骨盆倾斜角 腰椎前凸 

分 类 号：R682.3[医药卫生—骨科学]