[1]贺振年,康信勇,徐洪伟,等.骨盆矢状位参数对退行性腰椎滑脱症的影响[J].中医正骨,2015,27(06):19-22.
　HE Zhennian,KANG Xinyong,XU Hongwei,et al.Effect of pelvic parameters in the sagittal plane on degenerative lumbar spondylolisthesis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):19-22.
点击复制

骨盆矢状位参数对退行性腰椎滑脱症的影响()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年06期
页码:
19-22
栏目:
临床研究
出版日期:
2015-06-30

文章信息/Info

Title:
Effect of pelvic parameters in the sagittal plane on degenerative lumbar spondylolisthesis
作者:
贺振年1; 康信勇1; 徐洪伟1; 顾杰1; 郭剑1; 徐荣明2
1.浙江省宁波市北仑区人民医院,浙江 宁波 315800;
2.浙江省宁波市第六医院,浙江 宁波 315400
Author(s):
HE Zhennian1; KANG Xinyong1; XU Hongwei1; GU Jie1; GUO Jian1; XU Rongming2
1.The First Affiliated Hospital of Zhejiang University,Beilun branch,Ningbo 315800,Zhejiang,China 2.The sixth hospital of Ningbo city,Ningbo 315400,Zhejiang,China
关键词:
脊椎滑脱;  腰椎;  骨盆
Keywords:
spondylolysis;  lumbar vertebrae;  pelvis
摘要:
目的:探讨骨盆矢状位参数对退行性腰椎滑脱症的影响。方法:回顾性分析72例退行性腰椎滑脱症患者的影像学资料,男25 例,女47例。年龄45～78岁,中位数68岁。单节段滑脱65例,两节段滑脱7例。MeyerdingⅠ度滑脱48例、Ⅱ度滑脱24例。50例健康 成人,男22例,女28例。年龄45～70岁,中位数55岁。对72例患者及50例健康成人脊柱全长侧位X线片上的骨盆入射角、骨盆倾斜 角、骶骨倾斜角进行测量和比较分析,并对Ⅰ度与Ⅱ度腰椎滑脱患者的骨盆入射角进行比较。结果:退行性腰椎滑脱患者骨盆入 射角、骶骨倾斜角均大于健康成人组(54.90°±5.10°,50.46°±4.31°,t=2.770,P=0.007; 44.96°±4.87°,40.14°±4.06°,t=3.360,P=0.001); 退行性腰椎滑脱组骨盆倾斜角与健康成人组比较,差异无统计 学意义(9.94°±2.14°,10.54°±1.71°,t=-1.638,P=0.104)。Ⅱ度滑脱患者的骨盆入射角大于Ⅰ度滑脱患者的骨盆 入射角(58.14°±3.09°,53.06°±3.01°,t=-9.143,P=0.000)。结论:骨盆入射角、骶骨倾斜角增大,腰椎发生退行 性滑脱的风险会增加,同时骨盆入射角增大也会使腰椎滑脱的程度加重。
Abstract:
Objective:To explore the effect of pelvic parameters in the sagittal plane on degenerative lumbar spondylolisthesis.Methods:The imaging data of 72 patients with degenerative lumbar spondylolisthesis were analyzed retrospectively.The patients consisted of 25 males and 47 females,and ranged in age from 45 to 78 years(Mean=68 yrs).The lumbar spondylolisthesis located in single segment for 65 patients and two segments for 7 patients and belonged to Meyerding gradeⅠ(48)andⅡ(24).Fifty healthy adults(healthy adults group),consisted of 22 males and 28 females and ranged in age from 45 to 70 years(Mean=55 yrs),were also included.Pelvic incidence(PI),pelvic tilt(PT)and sacral slope(SS)on lateral X-ray film of total spine were measured and compared between 72 patients and 50 healthy adults.Meanwhile,the pelvic incidence(PI)was compared between grade Ⅰand gradeⅡlumbar spondylolisthesis.Results:PI and SS were larger in patients with degenerative lumbar spondylolisthesis compared to healthy adults(54.90+/-5.10 vs 50.46+/-4.31 degrees,t=2.770,P=0.007; 44.96+/-4.87 vs 40.14+/-4.06 degrees,t=3.360,P=0.001).There were no statistical differences in PI between the two groups (9.94+/-2.14 vs 10.54+/-1.71 degrees,t=-1.638,P=0.104).PI were larger in patients with gradeⅡdegenerative lumbar spondylolisthesis compared to those with gradeⅠdegenerative lumbar spondylolisthesis(58.14+/-3.09 vs 53.06+/-3.01 degrees,t=-9.143,P=0.000).Conclusion:The increament of PI and SS may increase the risk of degenerative lumbar spondylolisthesis,meanwhile,the increament of PI may also aggravate the degree of lumbar spondylolisthesis.

参考文献/References:

[1] Labelle H,Roussouly P,Berthonnaud E,et al.Spondylolisthesis,pelvic incidence,and spinopelvic balance:a correlation study[J].Spine(Phila Pa 1976),2004,29(18):2049-2054.
[2] Meyerding HW.Spondylolisthesis; surgical fusion of lumbosacral portion of spinal column and interarticular facets; use of autogenous bone grafts for relief of disabling backache[J].J Int Coll Surg,1956,26(5 part 1):566-591.
[3] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].3版.北京:人民军医出版社,2005:1734.
[4] Huang RP,Bohlman HH,Thompson GH,et al.Predictive value of pelvic incidence in progression of spondylolisthesis[J].Spine(Phila Pa 1976),2003,28(20):2381-2385.
[5] Kuntz C,Levin LS,Ondra SL,et al.Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature[J].J Neurosurg Spine,2007,6(2):104-112.
[6] Lee JH,Kim KT,Suk KS,et al.Analysis of spinopelvic parameters in lumbar degenerative kyphosis:correlation with spinal stenosis and spondylolisthesis[J].Spine(Phila Pa 1976),2010,35(24):E1386-E1391.
[7] Duval-Beaupère G,Schmidt C,Cosson P.A barycentremetric study of the sagittal shape of spine and pelvis:the conditions required for an economic standing position[J].Ann Biomed Eng,1992,20(4):451-462.
[8] Fergson AB.The clinical and roentgenographic interpretation of lumbosacral anomalies[J].Radiology,1934, (22):548-558.
[9] Roussouly P,Gollogly S,Berthonnaud E,et al.Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position[J].Spine(Phila Pa 1976),2005,30(3):346-353.
[10] Iguehi T,Wakami T,Kurihara A,etal.Lumbar multilevel degenerativ spondylolisthesis: radiological evaluation and faetors elated to anterolisthesis and retrolisthesis. [J] Spinal Disord Tech.2002,15(2):93-99.
[11] Mardjetko S,Albert T,Andersson G,et al.Spine/SRS spondylolisthesis summary statement.Spine,2005,30(6):S3.
[12] 田伟,陈安民.骨科学[M].北京:人民卫生出版社,2009:76.
[13] Curylo LJ,Edwards C,Dewald RW.Radiographic markers in spondyloptosis: implications for spondylolisthesis progression[J].Spine(Phila Pa 1976),2012,27(18):2021-2025.
[14] Marty C,Boisaubert B,Descamps H,et al.The sagittal anatomy of the sacrum among young adults,infants,and spondylolisthesis patients[J].Eur Spine J,2002,11(2):119-125.
[15] Boulay C,Tardieu C,Hecquet J,et al.Sagittal alignment of spine and pelvis regulated by pelvic incidence:standard values and prediction of lordosis[J].Eur Spine J,2006,15(4):415-422.
[16] 康信勇,徐荣明.脊柱-骨盆矢状面力线参数与腰椎退行性疾病的关系[J].中医正骨,2014,26(4):280-282.

相似文献/References:

[1]徐帮杰,杨楠,白伟杰,等.坐位定点旋转整复法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2015,27(11):17.
　XU Bangjie,YANG Nan,BAI Weijie,et al.Observation on the curative effect of fixed-point rotational reduction in sitting position in the treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):17.
[2]白春晓,贾育松,孙旗,等.中医药在腰椎间盘突出症围手术期应用的研究进展[J].中医正骨,2015,27(11):65.
[3]王少纯,周英杰.郭维淮教授运用活血益气通经汤治疗腰椎间盘突出症的经验[J].中医正骨,2015,27(11):75.
[4]邓红军.硫酸钙骨水泥椎体成形联合后路短节段椎弓根螺钉 内固定治疗创伤性胸腰椎骨折[J].中医正骨,2015,27(10):35.
[5]张莉,秦丹霞,张细姣.腹针治疗椎间盘源性腰痛[J].中医正骨,2015,27(10):38.
[6]苏洪,张雪林.患侧下肢牵引配合腰椎斜扳法治疗 极外侧型腰椎间盘突出症[J].中医正骨,2015,27(10):40.
[7]吴青坡,孙国绍,王林杰.后路椎管减压联合腰椎椎弓根钉动态稳定装置内固定 治疗单节段腰椎退行性疾病[J].中医正骨,2015,27(10):42.
[8]谢冬群,黄中梁,叶金丽.加强隔附子饼灸治疗肾阳虚型腰椎间盘突出症的 临床研究[J].中医正骨,2015,27(09):18.
　XIE Dongqun,HUANG Zhongliang,YE Jinli.Clinical study on intensive aconite root cake separated moxibustion in the treatment of kidney-yang-deficiency-type lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):18.
[9]沈海良,钱万锋,周骁栋.针刀松解联合局部封闭与口服中药治疗腰椎间盘突出症[J].中医正骨,2015,27(09):46.
[10]王仁灿,黄炎洪,潘伟江,等.45°肩踝悬吊牵引下撞击腰椎疗法治疗L5S1椎间盘突出症[J].中医正骨,2015,27(08):51.
[11]吴群生.后路减压椎弓根钉棒系统内固定联合椎间融合器植骨融合治疗腰椎滑脱症[J].中医正骨,2016,28(11):30.
[12]步开东,曹燕,何建,等.后路椎弓根钉棒系统内固定结合Cage椎间植骨融合术治疗创伤性Ⅳ度腰椎滑脱[J].中医正骨,2018,30(03):61.
[13]郭营,梅伟.后路减压椎板骨或髂骨椎间植骨融合治疗单节段重度腰椎滑脱症[J].中医正骨,2018,30(06):53.
[14]刘会文,陈绪林,曾景平,等.腰椎后路椎间自体骨移植Cage融合联合万向椎弓根螺钉内固定治疗腰椎峡部裂性滑脱[J].中医正骨,2018,30(07):70.
[15]叶永胜,张雪飞,吴显奎,等.减压融合经皮椎弓根螺钉与开放椎弓根螺钉内固定手术治疗腰椎滑脱的系统评价[J].中医正骨,2018,30(12):40.
　YE Yongsheng,ZHANG Xuefei,WU Xiankui,et al.Decompression and fusion combined with percutaneous pedicle screw internal fixation versus open pedicle screw internal fixation for treatment of lumbar spondylolisthesis:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(06):40.
[16]张荣,张向东,赵明宇.平乐正骨筋滞骨错理论在退行性腰椎滑脱症诊治中的应用[J].中医正骨,2019,31(04):61.
[17]王晟,吕立江,杨超,等.仰卧屈膝牵抖法治疗退行性腰椎滑脱症的生物力学作用机制[J].中医正骨,2019,31(09):39.
[18]郭明伟,吴强,林松,等.改良经皮骨水泥椎间盘成形术治疗高龄腰椎滑脱症[J].中医正骨,2022,34(06):77.
[19]吴紫烨,赵明宇,张向东,等.腰腹联合疗法治疗退行性腰椎滑脱症探析[J].中医正骨,2022,34(08):67.
[20]吴紫烨,赵明宇,张向东,等.平乐正骨筋滞骨错理论指导下的退行性腰椎滑脱症诊疗思维[J].中医正骨,2022,34(10):69.

备注/Memo

备注/Memo:
2014-10-31收稿 2015-01-02修回
更新日期/Last Update: 2015-06-30