Roussouly分型及脊柱-骨盆矢状位平衡参数与骨质疏松性椎体骨折预后的相关性分析

Correlation analysis of Roussouly classification and spine-pelvic sagittal balance parameters with prognosis of osteoporotic vertebral fracture

目的分析骨质疏松性椎体压缩性骨折(OVCF)病人中Roussouly分型及脊柱-骨盆矢状位平衡参数与预后的相关性。方法 2018年2月~2019年12月我院收治的OVCF病人162例,均采用经皮椎体后凸成形术(PKP)治疗,利用腰椎正、侧位X线片对脊柱-骨盆矢状位平衡参数进行测定。比较手术前后脊柱-骨盆矢状位平衡参数、Roussouly分型及预后指标,并分析其相关性。结果治疗后的骨盆倾斜角(PT)、骨盆入射角(PI)、骶骨倾斜角(SS)均低于治疗前,而腰椎前凸角(LL)高于治疗前;手术前后Roussouly分型差异明显。治疗后视觉模拟评分(VAS)及Cobb角(CA)明显降低,贝克指数(BI)明显恢复。平衡参数及Roussouly分型与预后指标存在相关性(P<0.05),其中PT、PI及Roussouly分型分别与VAS评分、Cobb角呈正相关关系(P<0.05),分别与BI呈负相关关系(P<0.05),SS、LL分别与BI呈正相关关系(P<0.05),与VAS评分、Cobb角呈负相关关系(P<0.05)。结论 OVCF可导致脊柱-骨盆矢状位参数失衡,而Roussouly分型及脊柱-骨盆矢状位平衡参数与预后存在相关性,PKP手术可促进脊柱-骨盆矢状位平衡的恢复,改善远期预后。

Objective To analyze the correlation between Roussouly classification,spine-pelvic sagittal balance parameters with prognosis in patients with osteoporotic vertebral compression fractures(OVCF).Methods A retrospective analysis of 162 cases of OVCF patients admitted to our hospital from February 2018 to December 2019 were treated with percutaneous kyphoplasty(PKP).The spine-pelvic sagittal position was analyzed by the front and lateral X-rays of the lumbar spine.The spine-pelvic sagittal balance parameters,Roussouly classification and the prognostic indicators before and after treatment were recorded.The correlation between spine-pelvic sagittal balance parameters and Roussouly classification and prognosis were calculated.Results The pelvic tilt angle(PT),pelvic incidence angle(PI),and sacral tilt angle(SS) after treatment were significantly lower than before treatment(P<0.05).The lumbar lordosis angle(LL) was significantly higher than before treatment(P<0.05).The difference of the Roussouly before and after surgery the type difference was obviously significant(P<0.05).After treatment,VAS score and CA were significantly reduced(P<0.05),while BI was significantly increased(P<0.05).Balance parameters and Roussouly classification had significant correlation with prognostic indicators(P<0.05).PT,PI,and Roussouly classification were positively correlated with VAS score and Cobb angle(P<0.05),and negatively correlated with BI respectively Relationship(P<0.05),SS and LL were positively correlated with BI(P<0.05),and negatively correlated with VAS score and Cobb angle(P<0.05).Conclusion OVCF can cause the patient’s spine-pelvic sagittal parameter imbalance.Roussouly classification and spine-pelvic sagittal parameter are correlated with prognosis.PKP surgery can promote the recovery and improve the prognosis.