老年胸腰椎骨折后凸畸形的矢状位脊柱-骨盆参数  

Variation of spinal-pelvic sagittal parameters of post-traumatic thoracolumbar kyphosis in elderly

作　　者：孙育良 万趸[1] 邓轩赓[1] 石华刚[1] 顾韬 崔伟 SUN Yu-liang;WAN Dun;DENG Xuan-geng;SHI Hua-gang;GU Tao;CUI Wei(Department of Spine Surgery,Orthopedics Hospital of Sichuan Province,Cheng-du 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《中国矫形外科杂志》2023年第24期2270-2273,共4页Orthopedic Journal of China

基　　金：四川省科技厅支撑项目(编号:2015SZ0190);四川省干部保健科研项目(编号:川干研2023-601)。

摘　　要：[目的]探讨老年陈旧性胸腰椎骨折后凸畸形(post-traumatic thoracolumbar kyphosis,PTK)患者脊柱-骨盆矢状位参数的特点及意义。[方法]回顾性研究2018年1月—2020年12月本院诊治的单节段老年PTK 65例患者的临床资料,并与同期单纯骨质疏松症(osteoporosis,OP)患者50例比较。分析影像测量指标的特征和之间的相关性。[结果] PTK组胸椎后凸角(thoracic kyphosis,TK)[(40.1±10.1)°vs (34.0±11.8)°,P<0.05]、胸腰椎后凸角(thoracolumbar kyphosis,TLK)[(38.1±10.8)°vs (19.1±6.6)°,P<0.05]、骨盆倾斜角(pelvic tilt,PT)[(29.5±12.0)°vs (21.2±5.9)°,P<0.05]和矢状面轴向距离(sagittal vertical axis,SVA)[(54.4±23.8) mm vs (26.4±18.3) mm,P<0.05]均显著大于OP组。PTK组腰椎前凸角(lumbar lordosis,LL)[(31.7±10.5)°vs (49.7±13.8)°,P<0.05]、骶骨倾斜角(sacral slope,SS)[(20.9±6.4)°vs (30.3±8.3)°,P<0.05]均显著小于OP组。PTK组失平衡率(53.9%)显著高于OP组(20.0%)(P<0.05)。PTK组的TK与TLK、SVA呈显著正相关(P<0.05),而PI与PT、SS呈显著正相关(P<0.05)。[结论]老年PTK患者脊柱-骨盆矢状位参数发生明显改变,易出现矢状位失平衡,重心前移,导致骨盆后旋转。[Objective] To investigate the characteristics and significance of variation in spinal-pelvic sagittal parameters of post-traumatic thoracolumbar kyphosis(PTK) in elderly.[Methods] A retrospective study was conducted on 65 patients who visited our hospital for single-segment PTK patients from January 2018 to December 2020.In addition,50 patients who visited our hospital for simple osteoporosis(OP) during the same period were used as the control.The spinal-pelvic sagittal parameters measured on X-ray films were analyzed to explore the characteristics and relationship among them.[Results] The PTK group was measured significantly greater thoracic kyphosis(TK)[(40.1±10.1)° vs(34.0±11.8)°,P<0.05],thoracolumbar kyphosis(TLK) [(38.1±10.8)° vs(19.1±6.6)°,P<0.05] and pelvic tilt(PT) [(29.5±12.0)° vs(21.2 ±5.9)°,P<0.05] and sagittal vertical axis(SVA) [(54.4±23.8) mm vs(26.4±18.3) mm,P<0.05] than the OP group.However,the former had significantly less lumbar lordosis(LL) [(31.7±10.5)° vs(49.7±13.8)°,P<0.05] and sacral slope(SS) [(20.9±6.4)° vs(30.3±8.3)°,P<0.05] than the latter.The sagittal imbalance rate proved 53.9% in the PTK group,while 20.0% in the OP group,which was statistically significant(P<0.05).Regarding correlation analysis,TK was positively correlated with TLK and SVA(P<0.05),whereas PI was positively correlated with PT and SS(P<0.05) in the PTK patients.[Conclusion] Elderly patients with PTK do have considerable variation in spinal-pelvic sagittal parameters,and are prone to sagittal imbalance,with forward shift of center of gravity and backward rotation of pelvis.

关 键 词：陈旧性胸腰椎骨折伴后凸畸形 骨质疏松 脊柱-骨盆参数 矢状位平衡 

分 类 号：R683.2[医药卫生—骨科学]