差异性(不均匀)沉降理论在退变性脊柱后凸畸形中的应用

Application of non-uniform settlement theory in spine degenerative kyphosis

目的研究差异性(不均匀)沉降理论指导下腰椎前缘/后缘比值的变化及椎弓根角度的变化。方法选择骨质疏松患者及非骨质疏松者各20例,均行CT检查,于CT矢状位重建图上测量胸椎第12节椎体(thoracic vertebra 12,T12)到腰椎第2节椎体(lumbur vertebra 2,L2)的前后缘比值,于CT平扫轴位图上选择椎弓根Magerl进针点,测量其椎弓根轴位上的角度。结果骨质疏松组T12～L2椎体前缘/后缘比值均小于非骨质疏松组,L1～L2椎弓根角度均小于非骨质疏松组,差异有统计学意义(P<0.05)。结论在骨质疏松患者中,腰椎前柱高度降低,椎体前缘/后缘比值减小;骨质疏松患者与非骨质疏松者相比,椎弓根角度变小;临床医生在骨质疏松患者的手术操作时应适当减少椎弓根进针角度。

Objective To examine the change of the ratio of anterior and posterior column and pedicle angle in lumbar vertebrae by using non-uniform settlement theory.Methods Twenty osteoporosis patients and20non-osteoporosis patients were selected for computed tomography(CT)examination.The ratio of anterior and posterior column of thoracic vertebra12(T12)to lumbar vertebra2(L2)was measured on sagittal CT reconstruction.Magerl needle insertion point was selected on CT cross view to measure the angle of pedicle angle.Results The anterior/posterior ratio of T12-L2vertebral body in osteoporosis group was lower than that in non-osteoporosis group,and the pedicle angle of L1-L2vertebral body was lower than that in non-osteoporosis group(P<0.05).Conclusion In patients with osteoporosis,the anterior column height of the lumbar spine was decreased and the ratio of anterior and posterior column of the vertebral body was decreased.The pedicle angle of patients with osteoporosis is smaller than that of non-osteoporosis patients.Clinicians should appropriately reduce the angle of pedicle insertion in the operation of osteoporosis patients.