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成人特发性脊柱侧凸患者脊柱-骨盆矢状位平衡分析 被引量:15
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作者 李危石 陈仲强 kirkham b wood 《中国脊柱脊髓杂志》 CAS CSCD 北大核心 2011年第3期207-211,共5页
目的:分析不同类型成人特发性脊柱侧凸(IS)患者的脊柱-骨盆矢状位平衡情况。方法:回顾分析2002年4月2009年4月收治的83例成人IS患者,男16例,女67例,年龄2084岁,平均43岁。在全脊柱站立位X线正侧位片(包括双侧髋关节)上测量侧凸Cob... 目的:分析不同类型成人特发性脊柱侧凸(IS)患者的脊柱-骨盆矢状位平衡情况。方法:回顾分析2002年4月2009年4月收治的83例成人IS患者,男16例,女67例,年龄2084岁,平均43岁。在全脊柱站立位X线正侧位片(包括双侧髋关节)上测量侧凸Cobb角、胸椎后凸角(TK)、胸腰段后凸角(TLJ)、腰椎前凸角(LL)、骨盆入射角(PI)、骶骨倾斜角(SS)、骨盆倾斜角(PT)以及C7铅垂线与S1后上缘的水平距离(SVA)。将患者分为胸弯组和腰弯组,比较两组患者的脊柱-骨盆矢状位参数,分析各参数间的相关性及各参数与年龄的相关性。结果:胸弯组共39例,平均年龄40.9岁,主弯角度平均45.8°;腰弯组共44例,平均年龄44.8岁,主弯角度平均39.5°。两组患者的年龄无统计学差异(P〉0.05)。两组的TK、TLJ、LL、PI、SS、PT均无统计学差异(P〉0.05),但腰弯组的SVA明显大于胸弯组(P〈0.05)。在≤40岁患者中,胸弯组和腰弯组患者的脊柱-骨盆矢状位序列无统计学差异(P〉0.05);在〉40岁患者中,腰弯组患者SVA和PT大于胸弯组(P〈0.05),余参数两组间无统计学差异(P〉0.05)。胸弯组9例(23.1%)出现脊柱失平衡,其中7例为负向失平衡;腰弯组12例(27.3%)出现脊柱失平衡,其中8例为正向失平衡。两组的LL与TK、SS有相关性,PI与PT、SS有相关性,SVA与LL、SS、PT有相关性,年龄与SVA、PT有相关性。与胸弯组不同,腰弯组患者的PI与LL无相关性,而年龄与LL、SS有相关性,PT与LL、SS有相关性。结论:成人IS中,胸弯和腰弯患者的骨盆形态无差别,骨盆与脊柱的矢状位序列密切相关,年龄与躯干平衡相关。胸弯患者易出现脊柱负向失平衡,而腰弯患者更易出现脊柱正向失平衡。 展开更多
关键词 特发性脊柱侧凸 脊柱 骨盆 矢状位平衡 成人
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Sagittal plane analysis of the spine and pelvis in adult idiopathic scoliosis 被引量:19
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作者 LI Wei-shi LI Gang +1 位作者 CHEN Zhong-qiang kirkham b wood 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第21期2978-2982,共5页
Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic ... Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic alignment in adult idiopathic scoliosis patients is poorly defined. This study was conducted to evaluate the sagittal alignment of pelvis and spine in adult idiopathic scoliosis patients.Methods The sagittal parameters of the spine and pelvis were analyzed in lateral standing radiographs of 124 patients (mean age 47.4 years) with adult idiopathic scoliosis, including thoracic kyphosis (TK), thoracolumbar junction kyphosis (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT) and C7 plumb line (C7PL). The patients were divided into three groups according to the age: 20-40 years, 41-64 years, and ≥65 years. The parameters were compared with those in normal adults and adolescent idiopathic scoliosis (AIS) patients. The relationship between all parameters as well as age and sagittal parameters were analyzed.Results The PI in patients with adult idiopathic scoliosis was 58.1°±13.0°, which was significantly higher than that in normal adults. The PT (19.9°±10.6°) was also higher than that in both normal adults and AIS patients, while the SS (38.1°±12.0°) was similar or smaller. As age increased, C7PL, PT and TJL increased while LL decreased. There was no relationship between age and both PI and TK. PT had the strongest statistical association with the C7PL.Conclusions PI is higher in adult idiopathic scoliosis than normal subjects. The PT is the most relevant pelvic parameter to the global sagittal alignment of the spine. Age significantly influences sagittal parameters of the spine and pelvis except the PI and TK. 展开更多
关键词 ADULT idiopathic scoliosis sagittal balance radiographic measures pelvic morphology
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