本文選題：退變性腰椎滑脫 + 退變性腰椎管狹窄癥�。� 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:1.比較脊柱骨盆參數(shù)在退變性腰椎滑脫和退變性腰椎管狹窄癥患者以及正常國(guó)人之間的差異。2.探討退變性腰椎滑脫發(fā)生及發(fā)展的危險(xiǎn)因素方法:1.從2016年2月至2017年2月期間住院病例中選出退變性腰椎滑脫及退變性腰椎管狹窄癥病例71例,其中退變性腰椎滑脫患者36例,男性2例,女性34例,平均年齡61.14±8.61(46~83)歲,退變性腰椎管狹窄癥患者35例,男性22例,女性13例,平均年齡60.57±9.67(40~81)歲。全部病例均具有完整的影像學(xué)資料全脊柱側(cè)位X-ray片,同時(shí)在全脊柱側(cè)位片上測(cè)量如下參數(shù):骨盆投射角(PI)、骶骨傾斜角(SS)、骨盆傾斜角(PT)、腰椎前凸角(LL)、胸椎后凸角(TK)、骨盆角(PA)、腰椎骨盆前凸(PR-LI—PR-L5)、總腰椎骨盆前凸角(PR-T12)、PR-S1、矢狀面垂軸(SVA)、腰4椎體傾斜角(L4S)、腰5椎體傾斜角(L5S)。2.所測(cè)退變性腰椎滑脫及腰椎管狹窄癥病例參數(shù)分別與正常國(guó)人脊柱骨盆參數(shù)進(jìn)行比較,采用兩獨(dú)立樣本t檢驗(yàn)比較兩組參數(shù)間的差異,兩組病例脊柱骨盆參數(shù)均采用pearson相關(guān)分別進(jìn)行相關(guān)性分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.退變性腰椎滑脫組PI、SS、LL明顯大于退變性腰椎管狹窄癥組及國(guó)人正常參考值(P0.01);2.PT、PA、SVA在退變性腰椎滑脫及退變性腰椎管狹窄癥組均明顯大于國(guó)人正常參考值(P0.01),退變性腰椎滑脫P(yáng)R-T12與正常參考值相比無(wú)差異(P0.05),退變性腰椎管狹窄癥組PR-T12小于正常參考值(P0.01);3.退變性腰椎滑脫P(yáng)R-L4、PR-L5及PR-S1明顯小于退變性腰椎管狹窄癥組(P0.01);4.退變性腰椎滑脫組PR-T12與PA(r=-0.829,P0.001)的相關(guān)性強(qiáng)于PR-T12與LL(r=0.664,P0.001)、TK(r=0.582,P0.001)的相關(guān)性,在退變性腰椎管狹窄癥組中,PR-T12與LL(r=0.854,P0.001)、TK(r=0.616,P0.001)相關(guān)性強(qiáng)于PR-T12與PA(r=-0.582,P0.001)的相關(guān)性。結(jié)論:1.為了維持全脊柱矢狀位平衡脊柱及骨盆空間結(jié)構(gòu)不斷發(fā)生改變,退變性腰椎滑脫及退變性腰椎管狹窄癥患者脊柱矢狀位結(jié)構(gòu)與骨盆結(jié)構(gòu)改變表現(xiàn)并不完全相同。2.高PI可能引起退變性腰椎滑脫發(fā)生及發(fā)展,退變性腰椎滑脫下腰椎骨盆前凸明顯小于退變性腰椎管狹窄癥(PR參數(shù)取正值)。3.退變性腰椎滑脫及退變性腰椎管狹窄癥患者可能具有不同的代償機(jī)制。
[Abstract]:Purpose 1.To compare the difference of spinal pelvic parameters between degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis and normal Chinese.To explore the risk factors for the occurrence and development of degenerative lumbar spondylolisthesis: 1.From February 2016 to February 2017, 71 cases of degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis were selected, including 36 cases of degenerative lumbar spondylolisthesis, 2 males and 34 females, with an average age of 61.14 鹵8.61 鹵460-83 years.There were 35 cases of degenerative lumbar spinal stenosis, including 22 males and 13 females, with an average age of 60.57 鹵9.67m 4081 years.All the patients had complete imaging data, all of them had lateral X-ray film of the spine.At the same time, the following parameters were measured on lateral radiographs of the whole spine: pelvis projection angle (Pi), sacral obliquity angle (SSS), pelvic obliquity angle (PTT), lumbar anterior kyphosis (LLL), thoracic kyphosis (TK), pelvic angle (PAA), pelvic protuberance (PR-LI-PR-L5), total lumbar pelvic kyphosis angle (PR-T12) PR-S1, sagittal.In the vertical axis of the shape plane, SVA, L4, L5, L5, L5, and L4, L4, and L5, respectively, were found in the vertical axis, L4, L4, L5, and L5, respectively.The parameters of degenerative lumbar spondylolisthesis and lumbar spinal stenosis were compared with those of normal Chinese.Pearson correlation was used to analyze the correlation between the two groups.The result is 1: 1.PISSLL in degenerative lumbar spondylolisthesis group was significantly higher than that in degenerative lumbar spinal stenosis group and Chinese normal reference value P0.01 / 2. PTPASVA in degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis group was significantly higher than that in Chinese normal reference value (P0.01), and degenerative lumbar spondylolisthesis group was significantly higher than that in Chinese normal reference value (P0.01).There was no difference between PR-T12 and normal reference value (P 0.05). The PR-T12 of degenerative lumbar spinal stenosis group was lower than that of normal reference value (P 0.01).PR-L _ 4 and PR-L _ 5 and PR-S1 of degenerative lumbar spondylolisthesis were significantly lower than that of degenerative lumbar spinal stenosis group (P 0.01).In degenerative lumbar spondylolisthesis group, the correlation between PR-T12 and P0.001 was stronger than that between PR-T12 and PR-T12. The correlation between PR-T12 and LLr0.854P0.001P0.001) was stronger than that between PR-T12 and PARM-0.582P0.001) in patients with degenerative lumbar spinal stenosis, the correlation between PR-T12 and P0.001 was stronger than that between PR-T12 and PARG-0.582P0.001. The correlation between PR-T12 and P0.001 was stronger than that between PR-T12 and PAR-0.582P0.001) in degenerative lumbar spondylolisthesis group (P 0.001), and the correlation between PR-T12 and LLR 0.854P 0.001 (P 0.001) was stronger than that between PR-T12 and PR-T12 (P 0.001).Conclusion 1.In order to maintain the sagittal balance of the whole spine and the spatial structure of the pelvis, the changes of the sagittal and pelvic structures in the patients with degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis were not identical.High Pi may lead to the occurrence and development of degenerative lumbar spondylolisthesis. The lumbar pelvic lordosis in degenerative lumbar spondylolisthesis is significantly lower than that in degenerative lumbar spinal stenosis.Degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis may have different compensatory mechanisms.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R681.5

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本文編號(hào)：1751538