不同类型腰椎退行性侧凸患者脊柱矢状位参数与骨盆参数相关性研究

摘要

目的：研究不同类型腰椎退行性侧凸患者脊柱矢状位参数与骨盆参数之间的相关性。方法选取在本院住院治疗的退行性腰椎侧凸患者共220例为实验组,并将其按脊柱矢状位形态分为三型(Ⅰ型、Ⅱ型、Ⅲ型),同期到本院进行健康体检,无脊柱疾病、下肢关节疾病以及畸形的健康人共140例作为对照组,测量所有研究对象脊柱矢状位参数和骨盆参数,并比较各组的差异性和各参数之间的相关性。结果四组间的脊柱后凸角(TK)比较差异无显著性(P>0.05)；腰椎段后凸角(TL)、腰椎前凸角(LL)、骨盆投射角(PI)、骨盆倾斜角(PT)和骶骨倾斜角(SS)的差异均有显著性(P<0.05)。Ⅲ型组TL明显高于其他三组(P<0.05)；Ⅱ型、Ⅲ型的LL和SS明显低于对照组和Ⅰ型组(P<0.05),Ⅱ型、Ⅲ型的LL和SS差异无显著性(P>0.05)；Ⅲ型组PI低于其他三组(P<0.05),其余各组差异无显著性(P>0.05)；Ⅱ型、Ⅲ型的PT高于对照组和Ⅰ型组(P<0.05),Ⅱ型、Ⅲ型的PT差异无显著性(P>0.05)；对照组中,TK与TL、LL、PI、SS有相关性,TL与LL、PI、SS具有相关性,LL与PI、PT、SS、矢状面垂直轴( SVA)具有相关性,LL与PI、PT、SS、SVA有相关性,PT和SS、SVA具有相关性；Ⅰ型组中,TK和TL、PI、SS具有相关性,TL和LL、PI、SS具有相关性,LL和SS、SVA具有相关性,PI和PT、SS具有相关性,PT和SS、SVA具有相关性；Ⅱ型组,TK与TL、SS具有相关性, TL和LL、PI、SS具有相关性,LL和SS、SVA具有相关性,PI和PT、SS具有相关性,PT和SS、SVA具有相关性；Ⅲ型组LL和SS、SVA具有相关性,PI和PT、SS具有相关性,PY和SS、SVA具有相关性；以上差异均具有显著性(P<0.05)。结论骨盆参数各参数之间和脊柱矢状位参数之间具有一定的相关性,且与腰椎退行性侧凸患者的病情和临床症状有一定的联系,虽然对临床具有一定的指导意义,但是要将该理论运用到临床还需要进一步的研究。%Objective To study the correlation between different types of lumbar degenerative scoliosis patients with spinal sagittal parameters and pelvic parameters. Method From 2010 January~2013 year in December to our hospital and in our hospital for degenerative lumbar scoliosis patients were 220 cases as experimental group, and divided into three types, corresponding to our hospital for health examination, no spinal disease, lower extremity joint disease and deformity of the total 140 cases of healthy people as control group, measuring all the research object of spinal sagittal parameters and pelvic parameters, and the correlation between the difference between the groups was compared and parameters. Result There were no significant differences in TK between the four groups (P>0. 05);the TL value, LL value, PI value, PT value and SS value of the differences were statistically significant (P<0. 05). TypeⅢgroup TL was significantly higher than the other three groups (P<0. 05); typeⅡ,ⅢLL value and SS value was significantly lower than the control group and typeⅠgroup (P<0. 05), typeⅡ, typeⅢLL and SS values had no significant differ-ence (P>0. 05);Ⅲgroup PI value is lower than the other three group (P<0. 05), no significant difference in other groups (P>0. 05);typeⅡ,ⅢPT was higher than that in control group and typeⅠgroup (P<0. 05), typeⅡ, typeⅢwas no significant difference between PT values (P>0. 05);in the control group, TK were significantly correlated with TL, LL, PI,TL, SS, and LL, PI, SS have correlation, correlation between LL and PI, with PT, SS, SVA, LL and PI, there is a correlation between the PT, SS, SVA, PT and SS, associated with SVA;typeⅠgroup, with a correla-tion between TK and TL, PI, SS, correlation TL and LL, PI, SS, LL and SS, associated with SVA, PI and PT, asso-ciated with SS, PT and SS, associated with SVA;typeⅡgroup, with the correlation between TK and TL, SS, TL and LL, associated with PI, SS, LL and SS, associated with SVA, with correlation PI and PT, SS, PT, SVA and SS are associated with typeⅢ;correlation between group LL and SS, SVA, PI and PT, SS is associated with the correlation between PY and SS, SVA, P<0. 05; above all, the difference was statistically significant. Conclusion Has certain correlation between various parameters conclusion pelvic parameters and spinal sagittal parameters, and certain and degenerative lumbar scoliosis patients and clinical symptoms are linked, although has certain guiding significance to the clinical, but further research is needed to apply the theory to clinical.