年龄因素及滑脱程度对退变性腰椎滑脱患者骨盆参数的影响

The influence of age and subluxation degree on pelvic parameters in patients with degenerative lumbar spondylolisthesis

目的探讨年龄因素及滑脱程度对退变性腰椎滑脱患者骨盆参数的影响。方法选取118例退变性腰椎滑脱（L4）患者，依据年龄分为三组：组Ⅰ38例，年龄〈35岁；组Ⅱ43例，年龄35—50岁；组Ⅲ37例，年龄〉50岁。所有患者于侧位X线片测量滑脱的严重程度（Meyerding分度）及骨盆矢状位参数：骨盆入射角（PI）、骶骨倾斜角（ss）、骨盆倾斜角（PT）。比较不同年龄及不同滑脱分度患者骨盆矢状位参数的差异。结果不同年龄患者的PI、SS、PT比较差异无统计学意义（P〉0．05）。MeyerdingI度患者86例，MeyerdingⅡ度患者32例。不同滑脱程度患者的PI比较差异无统计学意义（P〉0．05）。MeyerdingⅡ度的SS大于MeyerdingI度[（48．2±4．0）°比（40．4±3．5）°]，差异有统计学意义（P〈0．05），而胛小于MeyerdingⅠ 度[（17．3±2．1）°比（26．6±3．5）°]，差异有统计学意义（P〈0．01）。结论对于退变性腰椎滑脱患者而言，年龄及滑脱程度并未对PI产生显著影响，但滑脱程度的增大引起了PI的减小和SS的增大。

Objective To study the influence of age and subluxation degree on pelvic parameters in patients with degenerative lumbar spondylolisthesis. Methods One hundred and eighteen patients with degenerative lumbar spondylolisthesis （L4） were selected. The patients were divided into 3 groups according to age： group I 38 cases, age 〈 35 years; group II 43 cases, age 35 - 50 years; and group HI 37 cases, age 〉 50 years. The severity degree of subluxation （Meyerding degree） and sagittal pelvic parameters including pelvic incidence （PI）, sacrum slope （SS） and pelvic tilt （PT） were measured according to lateral X-ray film. The sagittal pelvic parameters were compared among different age and subluxation degree. Results There were no statistical difference in PI, SS and PT among the different age （P 〉 0.05）. Meyerding I degree was in 86 cases, and Meyerding I] degree was in 32 cases. There was no statistical difference in PI between Meyerding I degree and Meyerding I1 degree （P 〉 0.05）. The SS in Meyerding n degree was significantly higher than that in Meyerding I degree： （48.2 ± 4.0）° vs. （40.4 ± 3.5）°, and there was statistical difference （P〈 0.05）. But the PT in Meyerding Ⅱ degree was significantly lower than that in Meyerding I degree： （17.3 ± 2.1）° vs. （26.6 ± 3.5）°, and there was statistical difference （P 〈 0.01）. Conclusion In patients with degenerative lumbar spondylolisthesis, the age and subluxation degree can not affect the PI, but the subluxation degree increasing can decrease PI and increase SS.