腰椎间盘突出症伴功能性脊柱侧凸患者的腰骶部影像学形态分析

Analysis of lumbosacral region imaging morphology in patients with lumbar disc herniation and functional scoliosis

目的分析腰椎间盘突出症(LDH)伴功能性脊柱侧凸患者的腰骶部影像学形态。方法比较27例LDH伴功能性脊柱侧凸患者(LDH侧凸组)与27例单纯LDH患者(LDH组)、27例正常人群(对照组)的腰骶部影像学参数差异,其中包括腰椎前凸角(LL)、腰骶前凸角(LSL)、腰骶角(LS)、骶骨倾斜角(ST)。结果LDH侧凸组与对照组比较:LL、LS、ST参数LDH侧凸组均小于对照组(P<0.05),LSL参数LDH侧凸组大于对照组(P<0.05)。LDH侧凸组与LDH组比较:LL参数LDH侧凸组小于LDH组(P<0.05),LSL参数LDH侧凸组大于LDH组(P<0.05),LS及ST参数两组比较差异均无统计学意义(P>0.05)。结论LDH伴功能性脊柱侧凸患者存在明显的腰椎LL丢失及骶骨水平化加大的现象,这是患者为减轻疼痛而采取的一种保护性体位,其矢状面形态垂直化主要是因为腰椎前凸的丢失。

Objective To analyze the imaging morphology of lumbosacral region in patients with lumbar disc herniation(LDH)and functional scoliosis.Methods The lumbosacral region imaging parameters difference of 27 patients of LDH with functional scoliosis(LDH scoliosis group),27 patients of simple LDH(LDH group)and 27 normal population(control group)were compared,including lumbar lordosis angle(LL),lumbosacral lordosis angle(LSL),lumbosacral angle(LS)and sacral tilt angle(ST).Results The comparison of LDH scoliosis group and control group:LL,LS and ST parameters of LDH scoliosis group were all smaller than those of the control group(P<0.05),and the LSL parameter of LDH scoliosis group was larger than that of the control group(P<0.05).The comparison of LDH scoliosis group and LDH group:LL parameter of LDH scoliosis group was smaller than LDH group(P<0.05),LSL parameter of LDH scoliosis group was larger than LDH group(P<0.05),there were no statistical significance in LS and ST parameters between the two groups(P>0.05).Conclusions LDH patients with functional scoliosis have significant loss of lumbar LL and increased sacral horizontialization,which is a protective posture to relieve pain.The verticalization of sagittal plane is mainly due to the loss of lumbar lordosis.