腰椎滑脱复位和脊柱骨盆形态的相关性分析

Correlation between sagittal alignment of spine and pelvis and redution in patients with lumbar Spondylolisthesis

目的探讨矢状面形态对腰椎滑脱复位的影响及复位与矢状面变化的关系。方法分析本院34例滑脱患者,根据滑脱复位程度分为部分复位组(<50%)和完全复位组(>50%)。矢状面参数包括骨盆倾斜角(PT)、胸椎后凸角(TK)、腰椎前凸角(LL)、骶骨倾斜角(SS)、矢状面偏移(SVA)、骨盆入射角(PI)。2组间差异采用配对样本和独立样本t检验。结果完全复位组11例,部分复位组23例。术后LL明显低于术前(P=0.000);PT术前明显高于术后(P=0.017);而PI、SS、TK和SVA手术前、后无明显变化(P>0.05)。手术前后TK、LL、PI、SS、PT、SVA变化2组间差异无统计学意义(P>0.05)。2组间术前TK、LL、PI、SS、PT、SVA差异无统计学意义(P>0.05)。结论成人滑脱患者手术中,复位有利于减轻患者临床症状、提高患者生活质量,但复位并不能改善脊柱矢状面形态。

Objective To explore the influence of the morphology of the sagittal plane on reduction and the association of reduction with the morphology of the sagittal plane in patients with lumbar spondylolisthesis. Methods Thirty four patients with spondylolisthesis were analyzed. According to to the degree of reduction, all the cases were divided into partial reduction （〈50%）（Group A） and complete reduction （〉50%）（Group B）. Parameters of the sagittal plane included pelvic tilt angle（PT）, thoracic kyphosis angle（TK）, lumbar lordosis（LL）, sacral slope angle（SS）, sagittal vertical axis（SVA） and the pelvis incidence angle （PI）. Paired samples and independent sample t-tests were used to compare the difference between the two groups. Results Twenty three and 11 patients were included in group A and group B, respectively. Postoperative LL was significantly lower than that of the preoperation（P =0.000）; preoperative PT was significantly higher when compared with postoperative PT （P = 0.017）. However, there were no notable changes as for PI, SS, TK, and SVA between pre- and post-operation （P 〉0.05）. Changes of PI, PT, SS, TK, and SVA before and after operation, no significant difference was found between the two groups （P 〉0.05）. No significant difference in perioperative TK, LL, PI, SS, PT, SVA was found between the two groups （P 〉0.05）. Conclusion In adult spondylolisthesis surgery, the reduction is conducive to relieve the patient＇s symptoms and improve the patient＇s quality of life, but the reduction does not improve the patient＇s sagittal morphology.