腰椎间盘突出症患者脊柱-骨盆矢状位参数的研究

目的了解腰椎间盘突出症(lumbar disc herniation,LDH)患者脊柱-骨盆矢状位参数特点,探索矢状位参数是否存在年龄、性别差异,评价腰椎间盘突出症患者脊柱-骨盆矢状位参数与健康生活质量的相关性。方法回顾性分析第四军医大学唐都医院骨科病院脊柱外科2016年1月—2018年9月收治的120例腰椎间盘突出症患者,所有患者入院拍摄站立位脊柱全长正侧位片并采集完整的功能障碍指数调查表(oswestry disability index,ODI)数据。在全长片上测量患者的骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)、胸椎后凸角(thoracic kyphosis, TK)、腰椎前凸角(lumbar lordosis,LL)、PI-LL匹配值、矢状面垂直轴(sagittal vertical axis,SVA)并整理记录ODI值。根据性别、年龄段分组比较矢状位参数的差异,并分析矢状位参数和ODI值的相关性。结果不同性别LDH患者年龄、TK、LL、SVA、PI、PT、SS、PI-LL之间无显著性差异。男性ODI值为46.94±20.09,女性ODI值为55.92±21.26,不同性别比较差异有统计学意义(P=0.020)。结论 LDH患者不同性别、年龄段之间的脊柱-骨盆矢状位参数差异无统计学意义;但女性LDH患者的PI有明显大的趋势,仍需进一步证实。腰椎间盘突出症患者各脊柱-骨盆矢状位参数与生活质量之间并无相关性。本研究中女性LDH患者较差的生活质量与PI并无显著相关性,但根据以往报道,仍需进一步研究证实。

Study on the sagittal parameters of spino-pelvic alignment in patients with lumbar disc degeneration

Objective To understand the characteristics of sagittal parameters of spino-pelvic in patients with Lumbar disc herniation (LDH), explore the differences of sagittal parameters in age and sex, and evaluate the correlation between sagittal parameters of spino-pelvic and healthy life quality in patients with Lumbar disc herniation. Methods A retrospective analysis was made on the spinal surgery in the orthopaedic hospital of Tangdu hospital of the fourth military medical university. From January 2016 to September 2018, 120 patients with lumbar disc herniation were admitted to the hospital. On the full-length radiographs, we measured pelvic incidence (pelvic incidence, PI), pelvic tilt Angle (pelvic tilt, PT), sacral slope Angle (sacral slope, SS), thoracic kyphosis(TK), lumbar lordosis Angle (lumbar lordosis, LL), PI-LL matching values, sagittal plane vertical axis (sagittal vertical axis, SVA) and collates records ODI values. The differences of sagittal parameters were compared according to gender and age group, and the correlation between sagittal parameters and ODI values was analyzed. Results There was no significant difference in age, TK, LL, SVA, PI, PT, SS, PI-LL between male and female in patients with Lumbar disc herniation. The comparison of ODI values between male and female showed that male ODI was 46.94±20.09, female ODI was 55.92±21.26, which is significant differences (P=0.020). Conclusion There was no statistical difference in the sagittal parameters of the spino-pelvic between different genders and ages of LDH patients. However, the PI of female patients with LDH have a significantly larger trend. Further research is needed. There was no correlation between the spino-pelvic sagittal parameters and quality of life in patients with lumbar disc herniation. The poor quality of life of female patients with LDH in this study has no significant correlation with PI, but further research is needed to confirm it according to previous reports.