本文選題：高位腰椎間盤突出癥　切入點：骨盆入射角　出處：《中國脊柱脊髓雜志》2017年06期

【摘要】：目的:評估高位腰椎間盤突出癥(upper lumbar disc herniation,ULDH)患者的脊柱-骨盆矢狀面形態(tài)影像學表現(xiàn),探討脊柱-骨盆矢狀面形態(tài)在ULDH發(fā)病機制中的意義。方法:選取2007年1月~2016年12月行手術治療的29例ULDH患者,其中L1/2椎間盤突出9例,L2/3椎間盤突出16例,L1/2和L2/3雙節(jié)段椎間盤突出4例;正常無椎間盤突出志愿者58例為對照組。ULDH組年齡20~56歲,女10例,男19例;對照組年齡22~56歲,女21例,男37例。兩組的年齡、性別、體重指數(shù)比較均無統(tǒng)計學差異(P0.05)。在站立位全脊柱正側(cè)位X線片上測量兩組的脊柱-骨盆矢狀面形態(tài)學參數(shù),包括骨盆入射角(pelvic incidence,PI)、骨盆傾斜角(pelvic tilt,PT)、骶骨傾斜角(sacral slope,SS)、胸椎后凸角(thoracic kyphosis,TK)、腰椎前凸角(lumbar lordosis,LL)、胸腰段后凸角(thoracolumbar junctional angle,TLJ)、矢狀面平衡(sagittal vertical axis,SVA);ULDH組測量突出節(jié)段椎間盤前、后緣高度和椎間盤角度,對照組測量L1/2、L2/3椎間盤;觀察兩組是否存在滑脫及椎體楔形變,測量滑脫距離及楔形變角度。根據(jù)矢狀面形態(tài)進行Roussouly分型并比較兩組間脊柱-骨盆矢狀面參數(shù)和Roussouly分型結果。結果:ULDH組的PI、PT、SS和LL分別為36.0°±8.8°、12.5°±6.7°、23.4°±9.6°、36.1°±9.1°,明顯低于對照組的43.6°±8.6°、15.4°±6.7°、28.0°±9.1°、48.1°±9.0°(P均0.05);ULDH組的TK、TLJ和SVA分別為33.3°±11.0°、17.0°±6.6°、5.6±20.1mm,明顯高于對照組的26.7°±12.1°、6.2°±5.8°、-18.2±16.6mm(P均0.05)。ULDH組的L1/2椎間盤前、后緣高度分別為6.1±1.9mm和5.1±2.1mm,明顯低于對照組的9.7±1.8mm和8.5±2.4mm(P0.05);L2/3椎間盤前、后緣高度分別為7.1±2.1mm和5.1±2.7mm,明顯低于對照組的9.5±1.9mm和8.3±2.6mm(P0.05)。ULDH組L1/2和L2/3椎間盤角度分別為4.9°±3.0°和5.2°±2.9°,明顯高于對照組的3.2°±2.7°和3.1°±2.6°(P0.05)。ULDH組中后滑脫患者10例(34.5%),明顯高于對照組(0%)(P0.05)。ULDH組后滑脫距離5.3±1.9mm,24例(82.8%)椎間盤突出節(jié)段鄰近椎體存在明顯楔形變(8.7°±2.4°);而對照組僅2例(3.4%)存在腰段椎體楔形變,比例明顯低于ULDH組(P0.05)。ULDH組Roussouly分型Ⅰ、Ⅱ、Ⅲ、Ⅳ型所占比例分別為48.3%、31.0%、17.3%和3.4%,對照組分別為10.3%、46.6%、32.8%和10.3%,其中Ⅰ型在ULDH組所占比例明顯高于對照組(P0.05),其余分型在兩組間無顯著性差異(P0.05)。結論:ULDH患者以Roussouly分型Ⅰ型居多,PI較低,且較正常人群相應節(jié)段椎間盤高度顯著降低、椎間隙角度增加。
[Abstract]:Objective: to evaluate the morphologic features of spinal and pelvic sagittal plane in upper lumbar disc herniation (ULDH) patients with upper lumbar intervertebral disc herniation, and to explore the significance of spinal and pelvic sagittal plane morphology in the pathogenesis of ULDH.There were 58 cases of normal non-disc herniation volunteers. The age of ULDH group was 2056 years old, female group was 10 cases, male was 19 cases, control group was 22 56 years old, female was 21 cases, male was 37 cases.There was no significant difference in age, sex and BMI between the two groups (P 0.05).The spinal and pelvic sagittal morphologic parameters were measured in the standing position of the whole spine on the anteroposterior and lateral radiographs of the two groups.鍖呮嫭楠ㄧ泦鍏ュ皠瑙，

本文編號：1706979