脊柱侧弯矢状面平衡参数研究

The research advance of spinal sagittal balance parameters

[目的]脊柱侧弯是一种脊柱三维畸形,严重的侧弯往往需要手术矫正。目前已证实脊柱矢状面平衡参数对于优化手术策略至关重要。本文试图从总体上对这些参数进行分类,便于理解和分析,同时找出目前研究的趋势和进展。[方法]通过检索CNKI、Pub Med和ELSEVIER数据库,总结近几年脊柱矢状面平衡参数方面的研究成果,对比和分析相关参数。[结果]主要将矢状面平衡参数分为了6个部分:常用的矢状面整体平衡参数;特殊的矢状面整体平衡参数;常用的矢状面局部平衡参数;特殊的矢状面局部平衡参数;常用的骨盆参数;特殊的骨盆参数。[结论](1)脊柱矢状面平衡参数测量方法正逐渐由距离测量向角度和面积测量的变化;(2)多个参数与SVA关系密切;(3)脊柱外科手术计划的制定应充分考虑矢状面平衡参数。尽管有大量的文献报道,但大多数参数缺乏高质量的证据支持,需要进一步的研究从而更好的指导临床工作。

[Objective] Scoliosis is a tridimensional deformity of the spinal column. It is crucial for surgeons optimal operative strategies of scoliosis patients who have a surgery management. [Methods] This review summarizes spinal sagittal balance parameters by searching CNKI,Pub Med and ELSEVIER database for the period of 2010- 2014. [Results] We identified these parameters in detail in this paper,and compared of them,especially the SVA,C7 PL,PI,PT,SS and so on. This paper attempts to categorize these parameters in general. The parameters were divided into six aspects as namely： integral sagittal balance parameters（ common）; integral sagittal balance parameters（ special）; partly sagittal balance parameters（ common）;partly sagittal balance parameters（ special）; pelvic parameters（ common）; pelvic parameters（ special）. [Conclusion]（ 1） Measure methods of sagittal balance parameters have been taking place,surgeons paid attention to using angle measure and area measure instead of distance;（ 2） Some parameters,such as TPA,TPS,PR- L1,T1 sagittal angle,play an important role in sagittal balance;（ 3） The sagittal balance parameters can help surgical decision- making. Although various of literatures reported,we find lack of high- quilty evidence to support. More studies with consistent and improved methods are needed to provide better understanding of spinal sagittal balance and better guiding clinical work.