摘要
目的探讨单纯L5节段腰椎椎管狭窄症患者术前连续测量脊柱-骨盆矢状位相关参数的变化情况,分析变化参数对术前评估的价值及影响其变化的因素。方法纳入2017年3月至2022年5月在本院行单纯L5节段腰椎椎管狭窄症手术治疗的56例患者,所有患者术前均连续完成两次全脊柱X射线检查,相关参数包括:矢状面垂直轴(SVA)、颈椎前凸(CL)、胸椎后凸(TK)、胸腰椎角(TL)、腰椎前凸(LL)、骶骨斜率(SS)、骨盆倾斜(PT)、骨盆入射角(PI)、T_(1)斜率、C_(2)-C_(4)角度(C_(2-4A))和C_(4)-T_(1)角度(C_(4)-T_(1)),并根据两次全脊柱X射线检查之间的时间间隔、患者年龄进行亚组分析。结果所纳入56例患者的112张脊柱-骨盆矢状位图像,术前两次全脊柱X射线检查之间平均间隔(112±116)天。脊柱-骨盆矢状位相关参数,PI、PT和SS分别为(51.6±12.3)°、(26.7±12.8)°和(25.1±13.1)°,SVA和T_(1)斜率分别为(67.7±56.9)mm和(20.1±7.7)°。亚组分析显示,两次脊柱-骨盆矢状位检查时间间隔超过3个月时,参数SVA、PT、PI和T_(1)斜率差异有统计学意义(P<0.05);当年龄超过65岁时,参数SVA、PT、PI差异有统计学意义(P<0.05),而其他参数CL、TK、TL、LL、SS、C_(2)-C_(4)和C_(4)-T_(1)均无统计学差异(P<0.05)。结论通过术前连续全脊柱X射线检查发现,脊柱-骨盆矢状位相关参数SVA、PT、PI可作为单纯L5节段腰椎椎管狭窄症患者术前评估的重要参考指标,时间及年龄均是导致术前脊柱-骨盆矢状位相关参数变化的因素。
Objective To investigate the changes in parameters related to the spinal-pelvic sagittal position measured continuously in patients with lumbar spinal stenosis at the L5 segment alone preoperatively,and to analyze the value of the changed parameters for preoperative assessment and the factors influencing their changes.Methods 56 patients who underwent surgical treatment for lumbar spinal stenosis at the L5 segment alone in our hospital from March 2017 to May 2022 were included,and all patients completed two consecutive preoperative full spine X-rays with relevant parameters including:sagittal vertical axis(SVA),cervical convexity(CL),thoracic kyphosis(TK),thoracolumbar angle(TL),lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT),pelvic incidence(PI),T_(1)slope,C_(2)-C_(4)angle(C_(2-4A))and C_(4)-T_(1)angle(C_(4)-T_(1A)),and subgroup analysis based on the time interval between full spine X-rays,and patient age.Results The 112 spine-pelvis sagittal images of the 56 patients included had a mean interval of(112±116)days between preoperative full spine X-rays.The spine-pelvis sagittal correlation parameters,PI,PT and SS were(51.6±12.3)°,(26.7±12.8)°and(25.1±13.1)°,respectively,and the SVA and T_(1)slopes were(67.7±56.9)mm and(20.1±7.7)°,respectively.Subgroup analysis showed statistically significant differences in the parameters SVA,PT,PI and T_(1)slope when the interval between two spinal-pelvic sagittal examinations was more than 3 months(P<0.05).When age was more than 65 years,the differences in the parameters SVA,PT and PI were statistically significant(P<0.05),while the other parameters CL,TK,TL,LL,SS,C_(2)-C_(4)and C_(4)-T_(1)were not statistically different(P<0.05).Conclusion The spine-pelvis sagittal correlation parameters SVA,PT and PI were found to be important in the preoperative assessment of patients with simple L5 segmental lumbar spinal stenosis,with time and age being factors contributing to the preoperative change in the spine-pelvis sagittal correlation parameters.
作者
潘俊杰
李广军
敖炜群
PAN Junjie;LI Guangjun;AO Weiqun(Deqing County People's Hospital,Zhejiang 313200,China)
出处
《浙江创伤外科》
2023年第2期240-243,共4页
Zhejiang Journal of Traumatic Surgery
关键词
术前
脊柱-骨盆矢状位相关参数
单纯L5节段
腰椎椎管狭窄症
影响因素
Preoperative
Spinal-pelvic sagittal correlation parameters
Simple L5 segment
Lumbar spinal stenosis
Influencing factors
