脊柱骨盆矢状位参数对退行性腰椎滑脱症治疗效果的影响

Influence of sagittal parameters of the spine and pelvis on the therapeutic effect of degenerative lumbar spondylolisthesis

目的探讨脊柱骨盆矢状位参数对退行性腰椎滑脱症治疗效果的影响。方法回顾性分析2018年2月—2020年2月中山市中医院收治的62例退行性腰椎滑脱症患者作为观察组,另选取62例健康志愿者作为对照组。比较两组患者治疗前后脊柱骨盆矢状位参数变化,包括骨盆倾斜角(PT)、骨盆入射角(PI)、骶骨倾斜角(SS)、椎间高度(DH)、腰椎前凸角(LL)、滑脱度(SP),并分析上述指标变化与治疗获益指标视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分间的相关性。结果治疗前观察组的PI、PT大于对照组,SS、LL、DH小于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组的PI大于对照组,差异有统计学意义(P<0.05),两组的PT、SS、LL、DH比较,差异无统计学意义(P>0.05)。随访6个月,观察组的PT、SP小于治疗前,SS、LL、DH大于治疗前,差异有统计学意义(P<0.05),治疗前与随访6个月的PI比较,差异无统计学意义(P>0.05)。随访6个月,观察组的VAS评分和ODI评分均低于治疗前,差异有统计学意义(P<0.05)。相关性分析显示,PT、SS、LL、DH与VAS评分、ODI评分均呈正相关(P<0.05)。结论脊柱骨盆矢状位参数是衡量腰椎滑脱症患者腰椎功能的重要指标,其中PT、SS、LL、DH变化与患者疼痛、腰椎功能变化较为密切,通过测定PT、SS、LL、DH能够分析患者的治疗效果。

Objective To investigate the effect of sagittal parameters of spine and pelvis on the treatment of degenerative lumbar spondylolisthesis.Methods A total of 62 patients with degenerative lumbar spondylolisthesis and who treated in Zhongshan Hospital Traditional Chinese Medicine from February 2018 to February 2020 were retrospectively analyzed as the observation group,and 62 healthy volunteers were selected as the control group.The changes of sagittal parameters of spine and pelvis before and after treatment were compared between the two groups,including pelvic tilt angle(PT),pelvic incidence angle(PI),sacral tilt angle(SS),intervertebral height(DH),lumbar lordosis angle(LL),spondylolisthesis(SP),and the correlation between the changes of the above indexes and the visual analogue scale(VAS)and Oswestry disability index(ODI)were analyzed.Results Before treatment,the PI and PT of the observation group were higher than those of the control group,and the SS,LL,and DH were lower than those of the control group,the differences were statistically significant(P<0.05).After 6 months of follow-up,the PI of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).There were no significant difference in PT,SS,LL and DH between the two groups(P>0.05).After 6 months of follow-up,PT and SP in the observation group were lower than before treatment,while SS,LL and DH in the observation group were higher than before treatment,with statistical significance(P<0.05).There was no significant difference between PI before treatment and 6 months of follow-up(P>0.05).After 6 months of follow-up,the VAS score and ODI score of the observation group were lower than before treatment,and the differences were statistically significant(P<0.05).Correlation analysis showed that PT,SS,LL,DH were positively correlated with VAS score and ODI score(P<0.05).Conclusions The sagittal parameters of spine and pelvis are important indexes to measure lumbar function in patients with lumbar spondylolisthesis,and the changes of PT,SS,ll and DH are closely related to pain and lumbar function,by measuring Pt,SS,LL and DH,the treatment effect of patients can be analyzed by measuring PT,SS,LL and DH.