腰椎椎管狭窄症患者手术前后脊柱-骨盆矢状位参数变化

目的 研究腰椎椎管狭窄症(LSS)患者手术前后脊柱-骨盆矢状位参数的变化,并分析参数之间的相关性.方法 回顾性分析2015年1月—2015年7月在北京朝阳医院接受腰椎后路减压植骨融合内固定术治疗的63例LSS患者临床资料,选取同期60名健康成年志愿者作为对照组.采用疼痛视觉模拟量表(VAS)评分和Oswestry功能障...

Analysis of sagittal spinopelvic parameters in patients with lumbar spinal stenosis before and after operation

Objective To study the changes of sagittal spinopelvic parameters in the patients with lumbar spinal stenosis (LSS) before and after operation,and analyze the correlation between the parameters. Methods The data of 63 LSS patients who underwent posterior lumbar decompression,bone grafting,fusion and internal fixation in Beijing Chao-yang Hospital from January 2015 to July 2015 were retrospectively analyzed,and 60 healthy adult volunteers were selected as the control group. The visual analogue scale(VAS) score and Oswestry dysfunction index(ODI) were used to evaluate the pain and spinopelvic function. The pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),sagittal vertical axis(SVA),lumbar lordosis(LL) and thoracic kyphosis(TK) were measured on whole spine standing lateral roentgenograph of the control group and the LSS patients at pre-operation and the final follow-up,and compared between the LSS patients and the control group,and the changes of spinopelvic curvature were analyzed in LSS patients before and after operation. Pearson correlation analysis were used to explore the relationship between spinopelvic parameters. Results At the final follow-up,VAS score and ODI of the LSS patients were significantly improved compared with those before operation,all with a statistical significance(P<0.05). The preoperative PI,PT and SVA in LSS patients were significantly higher than those in the control group,and SS,LL and TK were lower than those in the control group,all with a statistical significance(P<0.05);the difference in PI was not statistically significant(P>0.05). Compared with pre-operation,PT,SS,LL,SVA and TK were significantly improved at the final follow-up in the LSS patients,all with a statistical significance(P<0.05),while PI did not change significantly. At the final follow-up,there was no significant difference in spinopelvic parameters between the LSS patients and the control group(P>0.05). In the LSS patients,whether at pre-operation or final follow-up,PI was positively correlated with PT,SS,LL and TK,but not with SVA. Conclusions Surgical treatment can improve the PT,SS,LL,SVA,TK and spinopelvic curvature and physiological function,and relieve pain symptoms. PI is not affected by surgery and positively correlated with PT,SS and LL. The ideal correction range of PT,SS and LL can be estimated by PI value before operation to guide the operation and obtain a satisfactory surgical outcome.