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L_(4)滑脱组(n=43)及L_(5)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L_(5)滑脱组比较,L_(4)滑脱组的ASI翻转有着更明显的翻转范围(P<0.01)。L_(4)滑脱组的骨盆入射角(pelvic incidence,PI)小于L_(5)滑脱组(P<0.05)。L_(4)滑脱组的腰椎前凸角(lumbar lordosis,LL)略小于L_(5)滑脱组,L_(4)滑脱组的LL翻转范围小于L_(5)滑脱组(P<0.05),这表明L_(4)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。L_(4)滑脱组与L_(5)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。
Objective To investigate the variability of sagittal spinal-pelvic parameters and their correlation with the degree of acetabular 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 typeⅡ,and they were divided into L_(4)slippage group(n=43)and L_(5)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 L_(5)slippage group,the L_(4)slippage group had a more significant range of ASI(P<0.01).The pelvic incidence(PI)of the L_(4)slippage group was smaller than that of the L_(5)slippage group(P<0.05).The lumbar lordosis(LL)in the L_(4)slippage group was slightly smaller than that in the L_(5)slippage group,while the results of the LL flip range in the two groups were opposite(P<0.05),indicating that patients with L_(4)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 L_(4)and L_(5)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 mobility,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.
作者
彭大霖
郑欣
闫梓文
金王亦
郭开今
PENG Dalin;ZHENG Xin;YAN Ziwen(Xuzhou Medical University,Jiangsu 221000,China.)
出处
《医学研究杂志》
2024年第3期95-99,共5页
Journal of Medical Research
基金
国家自然科学基金资助项目(81902244)
江苏省自然科学基金资助项目(BK20201154)。
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
Acetabular sagittal inclination
Lumbar lordosis
Lumbar spondylolisthesis
Spinal-pelvic parameters
