摘要:
目的：探讨腰椎间盘退变与脊柱骨盆矢状位参数的关系。方法：回顾性分析2013年1月至2015年12月76例脊柱外科腰椎间盘退变疾病（腰椎间盘突出症、退变性腰椎不稳症）患者的临床资料。在脊柱全长片上测量矢状位参数，包括胸椎后凸角（TK）、腰椎前凸角（LL）、骶骨倾斜角（SS）、骨盆倾斜角（PT）、骨盆入射角（PI）、矢状面垂直轴（SVA），分析各项指标与腰椎间盘退变位置、范围、程度的相关性。结果：年龄与退变位置（r＝-0.358, P＜0.01）、退变范围（r＝0.329, P＜0.01）、退变程度（r＝0.452, P＜0.01）明显相关； PI与退变位置明显相关（r＝-0.257, P＜0.05）；SVA与退变范围（r＝0.304, P＜0.01）、退变程度（r＝0.353, P＜0.01）明显相关。PI≤50°组患者位置值为4.14±0.64，PI＞50°组患者位置值为3.57±1.08，差异有统计学意义（P＜0.05）。结论：腰椎间盘退变位置受脊柱骨盆矢状面形态的影响，小PI人群倾向于L4/5、L5/S1椎间盘的退变，大PI人群更倾向于L3/4、L4/5椎间盘的退变。
Abstract:
Objective：To explore the correlation between the location, range and degree of lumbar disc degeneration (LDD) and sagittal parameters of spinopelvic alignment. Methods：The clinical data of 76 patients with lumbar disc degeneration (lumbar disc herniation and degenerative lumbar instability) who underwent surgery from January 2013 to December 2015 were retrospectively analyzed. Fulllength radiographs of the spine were taken to evaluate thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). The correlational analysis was carried out between the location, range and degree of lumbar disc degeneration and spinopelvic sagittal parameters. Results：Age was related to location (r＝-0.358, P＜0.01), range (r＝0.329, P＜0.01), degree (r＝0.452, P＜0.01). PI was related to degeneration location (r＝-0.257, P＜0.05). SVA was related to degeneration range (r＝0.304, P＜0.01) and degeneration degree (r＝0.353, P＜0.01).The value of degeneration location in patients with PI≤50° was 4.14±0.64, yet the value in patients with PI＞50° was 3.57±1.08 (P＜0.05).Conclusions：The location of lumbar disc degeneration are correlated with spinopelvic sagittal parameters. PI is an important factor affecting the location of lumbar disc degeneration. The population with PI≤50°are more likely to develop lumbar disc degeneration in L4/5 and L5/S1 discs, while the population with PI＞50°are more likely to develop lumbar disc degeneration in L3/4 and L4/5 discs.
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