不同年龄组正常人群最大胸椎后凸角的影响因素分析  

Influencing factors of maximal thoracic kyphosis in normal population of different age groups

作　　者：邓勇军 郑业虎 商金祥 陈锴[2] 杨长伟[2] 石志才[2] DENG Yongjun;ZHENG Yehu;SHANG Jinxiang;CHEN Kai;YANG Changwei;SHI Zhicai(Department of Orthopaedics,Affiliated Hospital of Shaoxing University of Arts and Sciences,Shaoxing 312000,Zhejiang,China;Department of Orthopaedics,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]绍兴文理学院附属医院骨科,绍兴312000 [2]海军军医大学(第二军医大学)第一附属医院骨科,上海200433

出　　处：《海军军医大学学报》2023年第8期1001-1005,共5页Academic Journal of Naval Medical University

摘　　要：目的通过分析不同年龄组正常人群的脊柱骨盆矢状面参数,报道正常人群脊柱骨盆参数的参考值,并探索导致正常人群最大胸椎后凸角(max TK)变化的因素。方法纳入2015年1月至2018年1月于绍兴文理学院附属医院(101人)和海军军医大学(第二军医大学)第一附属医院(90人)健康体检中心拍摄站立位正侧位全脊柱X线片的191名无症状健康志愿者,收集人口统计学数据及脊柱骨盆矢状面影像学参数。将健康志愿者分为年龄≤40岁组与年龄>40岁组,对比分析不同年龄组健康志愿者的矢状面参数,并对不同年龄组max TK的影响因素进行分析。结果年龄≤40岁组94人,平均年龄为(28.5±6.4)岁;>40岁组97人,平均年龄为(53.9±8.3)岁。年龄≤40岁组与>40岁组在T_(1)椎体矢状面倾斜角(T_(1)tilt;18.6°±6.5°vs 20.6°±5.5°,P=0.023)、胸椎后凸下端椎倾斜角(TVA;15.3°±5.3°vs 17.5°±6.6°,P=0.013)、max TK(33.9°±8.3°vs 38.0°±9.4°,P<0.001)、最大腰椎前凸角(max LL)与max TK的差值[max LL-max TK;16.0°(-9.0°~33.0°)vs 12.0°(-6.0°~41.0°),P=0.010]及矢状面躯干偏移距[SVA;-7.5(-58.0~48.0)mm vs 9.0(-53.0~49.0)mm,P=0.005]方面差异有统计学意义。在年龄≤40岁组,T_(1)tilt、TVA、max LL和骶骨倾斜角与max TK呈正相关(P均<0.01);在年龄>40岁组,年龄、T_(1)tilt、TVA和max LL与max TK呈正相关(P均<0.01),骨盆入射角与max TK呈负相关(P<0.05)。结论max TK随着年龄增长呈现均匀增大趋势,尤其在40岁以后max TK与年龄呈正相关。不同年龄阶段,骨盆对max TK改变的代偿表现出不同的模式。Objective To report the reference values of spine and pelvis parameters in the normal population by analyzing the sagittal parameters in different age groups,and to explore the impact factors of maximal thoracic kyphosis(max TK)in different age groups.Methods A total of 191 asymptomatic healthy volunteers who took standing full spine anteroposterior and lateral X-rays at Center of Physical Examination,Affiliated Hospital of Shaoxing University of Arts and Sciences(101 volunteers)and The First Affiliated Hospital of Naval Medical University(Second Military Medical University)(90 volunteers)from Jan.2015 to Jan.2018 were enrolled.Demographic statistical data and sagittal imaging parameters of spine and pelvis were collected.The volunteers were divided into age≤40 years old group and age>40 years old group,the sagittal parameters of different age groups were compared and analyzed,and the influencing factors of max TK in different age groups were analyzed.Results There were 94 volunteers in the age≤40 years old group with an average age of(28.5±6.4)years old,and 97 volunteers in the age>40 years old group with an average age of(53.9±8.3)years old.In the 2 different age groups,there were significant differences in T_(1) vertebral tilt(T_(1) tilt;18.6°±6.5°vs 20.6°±5.5°,P=0.023),thoracic lower end vertebral angle(TVA;15.3°±5.3°vs 17.5°±6.6°,P=0.013),max TK(33.9°±8.3°vs 38.0°±9.4°,P<0.001),maximal lumbar lordosis(max LL)-max TK(16.0°[-9.0°-33.0°]vs 12.0°[-6.0°-41.0°],P=0.010),and sagittal vertical axis(SVA;-7.5[-58.0-48.0]mm vs 9.0[-53.0-49.0]mm,P=0.005).T_(1) tilt,TVA,max LL and sacral slope were positively correlated with max TK in the age≤40 years old group(all P<0.01);age,T_(1) tilt,TVA and max LL were positively correlated with max TK in the age>40 years old group(all P<0.01),while pelvic incidence was negatively correlated with max TK(P<0.05).Conclusion Max TK shows a uniform increasing trend with age;especially in the population over 40 years old,max TK is positively correlated wit

关 键 词：正常人群 矢状面 最大胸椎后凸角 年龄 骨盆参数 

分 类 号：R687.3[医药卫生—骨科学]