峡部裂性腰椎滑脱的矢状位平衡与髋臼活动度的相关性研究
Correlation between Sagittal Balance and Acetabular Activity in Isthmic Cleft Lumbar Spondylolisthesis
彭大霖 1郑欣 2闫梓文 1金王亦 1郭开今3
作者信息
- 1. 221000 徐州医科大学
- 2. 510700 南方医科大学珠江医院
- 3. 221006 徐州医科大学附属医院
- 折叠
摘要
目的 研究不同节段峡部裂性腰椎滑脱患者矢状位脊柱-骨盆参数的差异以及与髋臼活动度的相关性.方法 选取91例单节段峡部裂性腰椎滑脱患者的资料,所有受试者均为Ⅱ度滑脱,根据病变部位不同分为L4滑脱组(n=43)及L5滑脱组(n=48).所有患者均拍摄腰椎过伸过屈位以及正侧位X线片,测量过伸过屈位和侧位片的矢状位髋臼前倾角(acetabular sagittal inclination,ASI)与脊柱-骨盆参数,对两组的ASI变化范围与脊柱-骨盆参数的差异性以及相关性进行统计学分析.结果 与L5滑脱组比较,L4滑脱组的ASI翻转有着更明显的翻转范围(P＜0.01).L4滑脱组的骨盆入射角(pelvic incidence,PI)小于L5滑脱组(P＜0.05).L4滑脱组的腰椎前凸角(lumbar lordosis,LL)略小于L5滑脱组,L4滑脱组的LL翻转范围小于L5滑脱组(P＜0.05),这表明L4滑脱的患者脊柱平衡所需的LL代偿更小,且脊柱活动范围更大.L4滑脱组与L5滑脱组的骨盆倾斜角(pelvic tilt,PT)以及骶骨倾斜角(sacral slope,SS)对比,差异均无统计学意义(P＜0.05).两组中均可见PI与PT、SS、LL翻转范围密切相关(P＜0.05),且ASI翻转范围与PI、PT、SS、LL翻转范围均密切相关(P＜0.05).结论 不同节段峡部裂性腰椎滑脱患者在同等滑脱程度下,髋臼活动程度、PI、LL以及腰椎活动度存在差异.
Abstract
Objective To investigate the variability of sagittal spinal-pelvic parameters and their correlation with the degree of ace-tabular mobility in patients with different segmental isthmic cleft lumbar spondylolisthesis.Methods The data of 91 patients with single-segment isthmic cleft lumbar spondylolisthesis diagnosed as Meyerding's type Ⅱ,and they were divided into L4 slippage group(n=43)and L5 slippage group(n=48)according to the location of the lesion.All patients had lumbar hyperextension-hyperflexion and lateral radiographs taken,and acetabular sagittal inclination(ASI)and spino-pelvic parameters were measured in the hyperextension-hyperflexion and lateral radiographs.The difference and correlation of ASI range and spine-pelvic parameters between the two groups were analyzed.Results Compared with the L5 slippage group,the L4 slippage group had a more significant range of ASI(P＜0.01).The pelvic incidence(PI)of the L4 slippage group was smaller than that of the L5 slippage group(P＜0.05).The lumbar lordosis(LL)in the L4 slippage group was slightly smaller than that in the L5 slippage group,while the results of the LL flip range in the two groups were opposite(P＜0.05),indicating that patients with L4 slippage had less LL compensation required for spinal balance and a greater range of spinal motion.There were no significant differences in pelvic tilt(PT)as well as sacral slope(SS)between the L4 and L5 slippage groups(P＞0.05).In both groups,PI was closely correlated with the flip ranges of PT,SS and LL(P＜0.05),and the ASI flip range was closely correlated with the flip ranges of PI,PT and SS(P＜0.05).Conclusion There are differences in the degree of acetabular mobil-ity,PI,LL and lumbar mobility in patients with isthmic fracture lumbar spondylolisthesis of different segments with the same degree of slippage.Spinal instability has an impact on acetabular mobility.
关键词
矢状位髋臼前倾角/腰椎前凸角/腰椎滑脱/脊柱-骨盆参数Key words
Acetabular sagittal inclination/Lumbar lordosis/Lumbar spondylolisthesis/Spinal-pelvic parameters引用本文复制引用
基金项目
国家自然科学基金(81902244)
江苏省自然科学基金(BK20201154)
出版年
2024
NETL
NSTL
万方数据