无症状汉族人群脊柱-骨盆矢状面参数测量影响因素的探索性研究

Measurement of sagittal parameters of spine and pelvis in asymptomatic Han population

目的本研究通过对无症状汉族人群脊柱-骨盆矢状面参数进行测量,建立汉族人群脊柱-骨盆参数的参考值范围,并对其影响因素性别、年龄、体质量指数等加以分析。方法选取2015年8月1日至2017年8月31日于首都医科大学附属北京天坛医院就诊患者入选的85名生活无症状汉族人群,入选者年龄为21~65岁。测量脊柱-骨盆矢状面参数,参数涵盖了骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,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)、颈椎前凸角(cervical lordosis,CL)、脊柱矢状位平衡(sagittal vertical axis,SVA)、总腰骨盆角(lumbopelvic lordosis angle,PR-T12)、脊柱骶骨角(spino-sacral angle,SSA),以及骶骨骨盆角(sacral pelvic angle,SPA)所涉及脊柱-骨盆矢状面参数的客观评估。参数组间比较采用t检验。各参数间以及与年龄、性别、体质量指数相关性采用Pearson相关系数。结果本研究85名志愿者,男性39名、女性46名,平均年龄男性(50.9±13.2)岁和女性(41.8±13.6)岁。PI,PT,SS,LL,TK,CL,SVA,PR-T12,SSA和SPA的平均值分别为51.1°±8.2°、18.5°±8.0°、32.8°±6.3°、36.7°±11.8°、20.8°±11.3°、11.2°±9.7°、(14.9±39.6)mm、75.6°±9.8°、122.9°±7.8°、54.3°±7.1°。本研究发现年龄与PI、PT呈正相关,与LL、TK呈负相关,与SS无明显相关性。男女两组TK、CL、SVA比较,差异有统计学意义(P<0.05)。其他比较,参数差异无统计学意义。LL、TK与体质量指数有相关性,其余参数未发现与体质量指数明显相关。结论脊柱-骨盆矢状面参数与个体的年龄、种群、性别及体质量指数都有相关性,本研究结果将为临床工作提供有参考意义的数据。

Objective To analysis the morphology and orientation characteristics of pelvis in normal Chinese adults and study the correlations among all the spinopelvic parameters and the correlations between these parameters and body properties like sex,age and body mass index(BMI).Methods A total of 85 asymptomatic Chinese adult volunteers from Beijing City with the age ranged from 21 to 65 years were enrolled in this study.The average age of the male were(46.0±14.1)years and the female were(41.8±13.6)years,respectively.Ten most important pelvic and spinal parameters were evaluated,which included pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),cervical lordosis(CL),thoracic kyphosis(TK),sagittal vertical axis(SVA),lumbopelvic lordosis angle(PR-T12),Spino-sacral angle(SSA),and sacral pelvic angle(SPA).Both the relationship among these parameters one another and the relationships between these parameters and age,sex,and BMI were assessed using the Pearson correlation analysis.Results The mean values of PI,PT,SS,LL,TK,CL,SVA,PR-T12,SSA,and SPA were 51.1°±8.2°,18.5°±8.0°,32.8°±6.3°,36.7°±11.8°,20.8°±11.3°,11.2°±9.7°,(14.9±39.6)mm,75.6°±9.8°,122.9°±7.8°,54.3°±7.1°,respectively.The results showed that the age is positively correlated with PI and PT,while negatively correlated with LL and TK.SS was correlated with ethnicity.Besides,TK,CL,and SVA were very different between the male and female groups.While LL and TK were slightly correlated with BMI.Conclusions The normal values of spinopelvic parameters were related with the age,ethnicity,sex,and BMI of the individuals.These results offered a significant reference for clinical work.