成人腰椎间盘突出症与腰椎管狭窄症患者脊柱骨盆矢状面差异

Difference of spin-pelvic sagittal alignment between lumbar disc herniation and lumbar canal stenosis in adults

目的:研究成人腰椎间盘突出症与腰椎管狭窄症患者在脊柱骨盆矢状面形态上的差异。方法 :检索2015年1月1日至2016年9月10日收治且有完整影像学资料的腰椎间盘突出症与腰椎管狭窄症患者88例,其中腰椎间盘突出症组42例,腰椎管狭窄症组46例,因年龄因素剔除22例后,腰椎间盘突出症组36例,腰椎管狭窄症组30例。测量两组脊柱骨盆矢状面形态学各指标,包括骨盆入射角(pelvic incidence,PI),骨盆倾斜角(pelvic tih,PT),骶骨倾斜角(sacral slope,SS),腰椎前凸角(lumbar lordosis,LL),胸椎后凸角(thoracic kyphosis,TK),胸腰联合角(thoracolumbar junction,TLJ),矢状面轴向垂直距离(sagittal vertical axis,SVA),矢状面轴向垂线落在骨盆的区域(sagittal vertical axis location,SVA-Location),T1脊柱骨盆倾斜角(T1-spinopelvic inclination,T1-SPI),T9脊柱骨盆倾斜角(T9-spinopelvic inclination,T9-SPI)。采用独立样本t检验对两组数据进行比较。结果:腰椎间盘突出症组的胸椎后凸角(TK)值小6°左右,P=0.031。其他参数两组差异均无统计学意义。结论:腰椎间盘突出症患者中胸椎后凸小,躯干更倾向于笔直;腰椎管狭窄患者胸椎后凸大,矢状面生理曲度更明显。

Objective：To study the difference of spino-pelvic sagittal alignment between lumbar disc herniation（LDH）and lumbar canal stenosis（LCS） in adults. Methods：The integrated imaging data of 88 patients with lumbar disc herniation（42 cases） or lumbar canal stenosis（46 cases） were searched from January 1,2015 to September 10,2016 in our hospital.Twenty-two cases were excluded because of age factor,36 cases of LDH（LDH group） and 30 cases of LCS（LCS group） were internalized in the study. The spino-pelvic parameters were measured including pelvic incidence（PI）,pelvic tilt（PT）,sacral slope（SS）,lumbar lordosis（LL）,thoracic kyphosis（TK）,thoracolumbar junction（TLJ）,sagittal vertical axis（SVA）,sagittal vertical axis location（SVA-Location）,T（1-spinopelvic inclination）（T1-SPI）,T（9-spinopelvic inclination）（T9-SPI）. Independent sample t test was used in order to analyze the above data. Results：Thoracic kyphosis（TK） in LDH group was smaller than that of LCS group（difference was about 6 degree）,there was significant difference between two groups（P=0.031）. And there were no significant differences in other parameters between two groups（P〈0.05）. Conclusion：The patients with lumbar disc herniation,the kyphosis of the thoracic spine is smaller,the truncus prones to the straight. The lumbar kyphosis is greater in patients with lumbar spinal stenosis,and the sagittal curvature of the lumbar spine is more obvious.