脊柱骨盆矢状面参数与PTED术后复发的关系研究

Relationship between sagittal parameters of spine and pelvis and recurrence after PTED

目的探讨脊柱骨盆矢状面参数与经皮椎间孔镜下椎间盘切除术(percutaneous transforaminal endoscopic discectomy,PTED)术后复发的关系。方法随机选择2016年11月~2021年11月本院收治的50例PTED术后复发患者以及50例未复发患者,分别设为复发组与未复发组。比较两组患者术前腰椎前凸角(lumbar lordosis,LL)、骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)以及腰椎矢状位曲线Roussouly分型等脊柱骨盆矢状面参数。结果复发组LL、PI、PT、SS均显著低于未复发组(P<0.05);复发组RoussoulyⅠ型、Ⅱ型患者所占比例高于未复发组,RoussoulyⅢ型、Ⅳ型患者所占比例低于未复发组,差异有统计学意义(P<0.05)。结论PTED术后复发患者的术前PI更低、RoussoulyⅠ型和Ⅱ型比例较高,可能与腰椎间盘突出症术后复发有关。

Objective To explore the relationship between the parameters of the sagittal plane of the spine and pelvis and the recurrence after percutaneous transforaminal endoscopic discectomy(PTED).Methods Fifty patients with recurrence after PTED and fifty patients without recurrence in our hospital from November 2016 to November 2021 were randomly selected and set as the recurrence group and the non-recurrence group,respectively.The preoperative lumbar lordosis angle(LL),pelvic incidence angle(PI),pelvic tilt angle(PT),sacral slope angle(SS),and lumbar sagittal curve Roussouly classification and other sagittal parameters of the spine and pelvis were compared between the two groups.Results The LL,PI,PT and SS of the recurrence group were significantly lower than those of the non-recurrence group,and the differences were statistically significant(P<0.05).The proportion of Roussouly typeⅠand typeⅡpatients in the recurrence group was higher than that of the non-relapse group,and the proportion of Roussouly typeⅢand typeⅣpatients was lower than that of the non-relapse group.The differences were statistically significant(P<0.05).Conclusion The preoperative PI of patients with recurrence after PTED is lower,and the proportion of Roussouly type I and type II is higher.The lumbar sagittal curve Roussouly type I,type II and low PI may be related to the recurrence of lumbar disc herniation after surgery.