[1]杨泽希 于淼 赵文奎 刘晓光**.35岁以下腰椎间盘突出症患者的脊柱-骨盆矢状位序列特征[J].中国微创外科杂志,2023,01(4):272-278.
　Yang Zexi,Yu Miao,Zhao Wenkui,et al.The Characteristics of Sagittal Alignment of Spinepelvis in Lumbar Disc Herniation in Patients Under 35 Years Old[J].Chinese Journal of Minimally Invasive Surgery,2023,01(4):272-278.
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35岁以下腰椎间盘突出症患者的脊柱-骨盆矢状位序列特征()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年4期
页码:
272-278
栏目:
临床研究
出版日期:
2023-04-25

文章信息/Info

Title:
The Characteristics of Sagittal Alignment of Spinepelvis in Lumbar Disc Herniation in Patients Under 35 Years Old
作者:
杨泽希 于淼 赵文奎 刘晓光**
(北京大学第三医院骨科，北京100191)
Author(s):
Yang Zexi;  Yu Miao;  Zhao Wenkui;  et al.
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China
关键词:
腰椎间盘突出症; 脊柱-骨盆矢状位序列; 脊柱畸形
Keywords:
Lumbar disc herniation; Sagittal alignment of spinepelvis; Spinal deformity
文献标志码:
A
摘要:
目的探讨我国35岁以下青年腰椎间盘突出症患者的脊柱-骨盆矢状位序列的特征。方法回顾性分析2017年1月~2019年1月我院骨科及疼痛科治疗74例35岁以下腰椎间盘突出症患者的临床影像学资料，描述患者的脊柱-骨盆矢状位参数，与我院既往无症状健康青年人的脊柱-骨盆矢状位序列的结果进行比较。结果35岁以下青年腰椎间盘突出症患者较无症状健康青年人骨盆入射角（pelvic incidence,PI)、骨盆倾斜角（pelvic tilt,PT)显著增加（P=0.003,P=0000），腰椎前凸角（lumbar lordosis,LL)、骶骨倾斜角（sacral slope,SS)显著减少(均P=0.000)，胸椎后凸角（thoracic kyphosis,TK)无统计学差异(P=0062)，18例出现矢状位轴向距离（sagittal vertical axis,SVA)>5 cm。患者LL与TK、SS、脊柱骶骨角（spinal sacral angle,SSA)高度相关，与PT、SVA、骶-股距离（sacrofemoral distance,SFD)中度相关，与PI低度相关。SVA与SSA高度相关，与TK、LL、PT、SS、SFD中度相关。患者的胸腰段拐点约位于L2椎体下半部水平，腰椎前凸曲度的顶点约位于L4椎体的上半部水平。结论35岁以下腰椎间盘突出症患者的脊柱-骨盆矢状位序列特征为胸椎和腰椎曲度丢失，骨盆后旋，全脊柱前倾，胸腰段拐点较低，参与腰椎前凸椎体较少。这种形态学特征改变了脊柱的力学结构。
Abstract:
ObjectiveTo explore the characteristics of sagittal alignment of spinepelvis in lumbar disc herniation in Chinese patients under 35 years old.MethodsThe clinical imaging data of 74 lumbar disc herniation patients under 35 years old in our hospital from January 2017 to January 2019 were collected and retrospectively analyzed. The sagittal parameters of the spine and pelvis were measured and compared to our previous research of sagittal alignment in asymptomatic healthy young persons.ResultsAs compared with asymptomatic healthy young persons, lumbar disc herniation patients under 35 years old showed a significant increase in pelvic incidence (PI) and pelvic tilt (PT） (P=0.003 and P=0.000) and a significant decrease in lumbar lordosis (LL) and sacral slope (SS) (all P=0.000). There was no statistically significant difference in thoracic kyphosis (TK) (P=0.062), and 18 cases showed sagittal vertical axis (SVA)>5 cm. The LL was highly correlated to TK, SS, and spinal sacral angle (SSA）, moderately correlated to PT, SVA, and sacrofemoral distance (SFD), and weakly correlated to PI. The SVA was highly correlated to SSA and moderately correlated to TK, LL, PT, SS, and SFD. The inflection point of the thoracolumbar segment was located at the lower part of L2 vertebra and the apex of lumbar lordosis was located at the upper part of L4 vertebra.ConclusionsThe sagittal alignment of spinepelvis in lumbar disc herniation patients under 35 years old is characterized as loss of curvature in the thoracic and lumbar vertebrae, pelvic supination, and total spinal forward tilt. The inflection point of the thoracolumbar segment is lower and less vertebrae are involved in lumbar lordosis. The sagittal alignment alters the mechanical structure of the spine.

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备注/Memo

备注/Memo:
基金项目：北京大学第三医院临床重点项目(BYSYZD2019001)；首都卫生发展科研专项(2020-2-4091)；北京大学第三医院临床重点项目（孵育项目）（BYSYZD2019017）**通讯作者，Email:xgliudoctor@163.com
更新日期/Last Update: 2023-06-29