骨盆矢状位参数变化与腰椎滑脱症患者临床疗效的相关性研究

摘要

目的 研究骨盆矢状位参数变化与腰椎滑脱症患者临床疗效的相关性.方法 选择2012-04-2015-04期间在我院接受腰椎融合手术的75例腰椎滑脱症患者为观察组,接受椎间孔腰椎椎体间融合术;选择同一时间段内在我院接受体检的健康志愿者60例作为对照组.行腰椎侧位X线检查并测定骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、腰椎前凸角(LL)、椎间隙高度(DH);采用VAS量表、JOA量表以及ODI指数评价疼痛程度和功能障碍程度.结果 手术前,腰椎滑脱患者PI、PT明显高于对照组,SS、LL、DH明显低于对照组(t=4.979～27.630,P＜0.05);手术后3个月,腰椎滑脱患者PI、PT明显高低于手术前,SS、LL、DH明显高于手术前(t=3.957～23.995,P＜0.05),VAS评分、ODI指数低于手术前,JOA评分高于手术前(t=25.524～39.151,P＜0.0S);PI、PT与VAS评分、ODI指数呈正相关,与JOA评分呈负相关(r=-0.425～0.412,P＜0.05);SS、LL、DH与VAS评分、ODI指数呈负相关,与JOA评分呈正相关(r=-0.432～0.415,P＜0.05).结论 骨盆矢状位参数PI、PT、SS、LL、DH与腰椎滑脱症患者手术前后疼痛程度、功能障碍程度的改善密切相关.%Objective To study the correlation between the changes of pelvic sagittal parameters and clinical efficacy in patients with lumbar spondylolisthesis.Methods 75 patients with lumbar spondylolisthesis received lumbar fusion surgery from April 2012 to April 2015 were enrolled as the observation group,received transforaminal lumbar interbody fusion.60 healthy volunteers received physical examination in our hospital during the same period were enrolled as control group.Lumbar lateral X-ray examination was performed and pelvic incidence angle (PI),pelvic tilt(PT),sacral inclination angle (SS),lumbar lordosis angle (LL),intervertebral height (DH) were determined.VAS table,JOA scale and ODI index were used to evaluate the degree of pain and dysfunction.Results PI,PT of observation group before surgery were higher than the control group,SS,LL and DH were lower than the control group,the differences between the two groups were statistically significant(P＜0.05).3 months after surgery,PI,PT and VAS,ODI scores of patients with lumbar spondylolisthesis were lower than those before surgery,SS,LL,DH and JOA score were higher than those before surgery,the differences between before and after surgery were statistically significant (P＜0.05).PI,PT were positively correlated with VAS score,ODI index,negatively correlated with JOA score.SS,LL,DH were negatively correlated with VAS score,ODI index,positively correlated with JOA score.Conclusion Pelvic sagittal parameters PI,PT,SS,LL,DH are closely related to the improvement of pain degree and dysfunction degree before and after surgery.