腰椎骶化者腰椎生理曲度差异及临床意义

Lumbar Spinal Physiological Curvature and Its Clinical Significance in Patients with Lumbar Sacralization

目的比较分析Ⅱ、Ⅲ、Ⅳ型腰椎骶化者与无腰椎骶化者的腰椎生理曲度差异,并探讨其临床意义。方法从南昌大学第一附属医院影像科随机选取腰椎骶化患者216例及对照组(无腰椎骶化者)1412例。腰椎骶化患者根据Castellvi分型方法分为Ⅱ、Ⅲ及Ⅳ型。比较腰椎骶化患者与对照组间、男女间腰骶角(Ferguson法,F)、腰骶角(Wiltse法,LSA)、腰骶角(Grogkopff法,G)和腰椎前突指数的差异性。结果腰椎骶化患者与对照组腰骶角(F)、腰骶角(G)和腰椎前突指数比较差异有统计学意义(P<0.001);对照组腰骶角(F)、腰骶角(G)和腰椎前突指数男性与女性比较差异有统计学意义(P<0.05);腰椎骶化患者腰骶角(F)和腰椎前突指数男性与女性比较差异有统计学意义(P<0.05)。Ⅱ型和Ⅲ型间腰骶角(F)、腰骶角(G)和腰椎前突指数比较差异有统计学意义(P<0.05);Ⅱ型和Ⅳ型间腰骶角(G)比较差异有统计学意义(P<0.05)。结论腰椎骶化者腰椎生理曲度发生改变,且男女之间腰椎生理曲度存在差异。

Objective To compare the lumbar spinal physiological curvature between patients with type Ⅱ, Ⅲ or IV lumbar sacralization and subjects without lumbar sacralization, and to investigate its clinical significance. Methods A total of 216 patients with lumbar sacralization and 1412 control subjects without lumbar sacralization were randomly selected from the Department of Radiology of the First Affiliated Hospital of Nanchang University. According to Castellvi＇s classification, patients were classified as type Ⅱ, Ⅲ or Ⅳ. The lumbosacral angle （Ferguson method, F）, lumbosacral angle （ Wiltse method, LSA）, lumbosacral angle （Grogkopff method, G） and lumbar protrusion index were compared between patients with lumbar sacralization and control subjects,as well as between men and women. Results There were significant differences in F lumbosacral angle, G lumbosacral angle and lumbar protrusion index between lumbar sacralization patients and control subjects （P〈0. 001）. In control group, differences in F lumbosacral angle, G lumbosacral angle and lumbar protrusion index were significant between men and women（P〈0.05）. In lumbar sacralization group,differences in F lumbosacral angle and lumbar protrusion index were significant between men and women （P〈0. 05）. Moreover, differences in F lumbosacral angle, G lumbosacral angle and lumbar protrusion index were significant between patients with type Ⅱ lumbar sacralization and patients with type Ⅲ lumbar sacralization（P〈0.05）. The difference in G lumbosacral angle was significant between patients with type Ⅱ lumbar sacralization and patients with type Ⅳ lumbar sacralization （P〈0. 05）.Conclusion Lumbar spinal physiological curvature is changed in lumbar sacralization patients and differs between men and women.