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
目的：探讨后路长节段固定治疗成人退行性脊柱畸形的效果以及远端并发症的发生率。方法：回顾性分析2010年1月~2015年1月在我院接受一期后路长节段椎弓根螺钉固定矫形治疗的成人脊柱畸形患者，病例入选标准：（1）诊断为成人退行性脊柱...目的：探讨后路长节段固定治疗成人退行性脊柱畸形的效果以及远端并发症的发生率。方法：回顾性分析2010年1月~2015年1月在我院接受一期后路长节段椎弓根螺钉固定矫形治疗的成人脊柱畸形患者，病例入选标准：（1）诊断为成人退行性脊柱畸形；（2）年龄超过50岁；（3）影像学满足冠状面Cobb角度〉20°，或者矢状面平衡（SVA）〉5cm；（4）后方腰椎固定融合在4个节段以上；（5）随访时间在12个月以上。分析患者的人口学特点、影像学参数、健康相关生活质量评分和远端并发症等资料。结果：共纳入74例患者，其中远端固定椎在L5的患者43例（L5组），固定在S1的患者22例（S1组），固定到髂骨的患者9例（髂骨组）。随访12~64个月，平均28.8个月，三组患者术后冠状面Cobb角、冠状面平衡（CSVL）、矢状面平衡（SVA）、PI-LL、PT角度与术前比较均有显著性改善（P〈0.05）。术后健康相关生活质量评分（ODI和SF-12 PCS）与术前相比均得到明显改善（P〈0.05）。远端并发症总的发生率为29.7%（22/74），保留L5/S1椎间盘患者远端并发症的发生率显著性高于L5/S1融合的患者（39.5% vs 16.1%），保留L5/S1椎间盘是远端并发症的独立危险因素（P=0.03）。结论：长节段固定融合治疗成人退行性脊柱畸形能够改善患者的健康相关生活质量评分，获得满意的临床效果；保留L5/S1椎间盘发生远端并发症的风险更高。展开更多
文摘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.
文摘目的：探讨后路长节段固定治疗成人退行性脊柱畸形的效果以及远端并发症的发生率。方法：回顾性分析2010年1月~2015年1月在我院接受一期后路长节段椎弓根螺钉固定矫形治疗的成人脊柱畸形患者，病例入选标准：（1）诊断为成人退行性脊柱畸形；（2）年龄超过50岁；（3）影像学满足冠状面Cobb角度〉20°，或者矢状面平衡（SVA）〉5cm；（4）后方腰椎固定融合在4个节段以上；（5）随访时间在12个月以上。分析患者的人口学特点、影像学参数、健康相关生活质量评分和远端并发症等资料。结果：共纳入74例患者，其中远端固定椎在L5的患者43例（L5组），固定在S1的患者22例（S1组），固定到髂骨的患者9例（髂骨组）。随访12~64个月，平均28.8个月，三组患者术后冠状面Cobb角、冠状面平衡（CSVL）、矢状面平衡（SVA）、PI-LL、PT角度与术前比较均有显著性改善（P〈0.05）。术后健康相关生活质量评分（ODI和SF-12 PCS）与术前相比均得到明显改善（P〈0.05）。远端并发症总的发生率为29.7%（22/74），保留L5/S1椎间盘患者远端并发症的发生率显著性高于L5/S1融合的患者（39.5% vs 16.1%），保留L5/S1椎间盘是远端并发症的独立危险因素（P=0.03）。结论：长节段固定融合治疗成人退行性脊柱畸形能够改善患者的健康相关生活质量评分，获得满意的临床效果；保留L5/S1椎间盘发生远端并发症的风险更高。
