摘要
目的观察退行性腰椎滑脱症患者术后脊柱骨盆矢状面参数变化,并评估术后疗效,探讨脊柱骨盆矢状面参数变化与临床疗效的相关性。方法纳入自2015-06—2017-01行后路腰椎椎体间融合术(PLIF)的30例L4、5退行性腰椎滑脱症。测量手术前后脊柱骨盆矢状面参数:骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、腰椎前凸角(LL)、滑脱程度(SD)、椎间隙高度(DH)。采用Pearson相关分析脊柱骨盆矢状面参数与ODI指数、VAS评分的相关性。结果本组30例均获得3~19(12.73±7.06)个月随访。末次随访时VAS评分、ODI指数、PT、SS、LL、SD、DH较术前明显改善,差异有统计学意义(P<0.05);而PI与术前比较差异无统计学意义(P>0.05)。Pearson相关分析显示,术前PT、SD与术前ODI指数、VAS评分呈正相关,SS、LL、DH与ODI指数、VAS评分呈负相关,而PI与ODI指数、VAS评分无明显相关性。手术前后PT、SS、LL、SD、DH的变化值与ODI指数及VAS评分改善率呈正相关。结论退行性腰椎滑脱症患者术后脊柱骨盆矢状面参数改变与临床疗效存在相关性,术中应尽可能恢复脊柱骨盆矢状面平衡以获得良好疗效。
Objective To observe changes of sagittal parameters of spine and pelvis in patients with degenerative lumbar spondylolisthesis after surgery, and to evaluate the postoperative effect, and to investigate the correlation between the changes of parameters and clinical outcomes. Methods From June 2015 and January 2017, 30 cases of L4,5 degenerative lumbar spondylolisthesis with posterior lumbar interbody fusion （PLIF） were selected. Spine-pelvic sagittal parameters were measured before and after operation： pelvic incidence（PI）, pelvic tih（PT）, sacral slope（SS）, lumbar lordosis（LL）, slip distance（SD）, disc height（DH）. Pearson correlation was used to analyze the correlation between the sagittal parameters of spine and pelvis and the ODI index, VAS score. Results All 30 cases were followed up for 3-19 （12.73_＋7.06）months. At the end of the follow-up VAS score, ODI index, PT, SS, LL, SD, DH were significantly improved after operation （P 〈0.05）, but there was no significant difference in PI before and after operation （P 〉0.05）. Pearson correlation analysis showed that preoperative PT, SD and preoperative ODI index, VAS score was positively correlated, SS, LL, DH and ODI index, VAS score was negatively correlated, while PI and ODI index, VAS score had no significant correlation. The changes of PT, SS, LL, SD and DH were positively correlated with the ODI index and VAS score. Conclusion There is a correlation between the change of spinal sagittal parameters and the clinical efficacy in patients with degenerative spondylolisthesis. During the operation, spine sagittal balance should be restored as far as possible in order to obtain good curative effect.
作者
申鹏飞
郑翰林
李树怀
高双全
周振涛
张亦庚
SHEN Peng-fei ZHENG Han-lin LI Shu-huai GAO Shuang-quan ZHOU Zhen-tao ZHANG Yi-geng(Department of Orthopedics, Tangshan Worker＇s Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, Chin)
出处
《中国骨与关节损伤杂志》
2017年第9期920-923,共4页
Chinese Journal of Bone and Joint Injury
