【摘要】：目的:測量志愿者人群脊柱全長X片脊柱-骨盆失狀面參數(shù),探討其相關(guān)性,以腰椎前凸角(LL)及胸腰椎轉(zhuǎn)折椎間隙(TLIP)為基礎(chǔ)提出對成人脊柱-骨盆矢狀面的新分型。方法:拍攝111例成人志愿者脊柱全長片。志愿者納入標準:1、年齡20～60歲,2、無脊柱及下肢骨關(guān)節(jié)疾病史,3、無長期腰背痛史,4、X片無脊柱畸形,輕度椎體楔形變視為正常椎體變異�？傆嬇�56例,男55例。一般參數(shù):年齡、體重、身高。X片測量參數(shù)包括:胸椎后凸角(TK)、胸腰段后凸角(TLK)、腰椎前凸角(LL)、骶骨傾斜角(SS)、骨盆傾斜角(PT)、骨盆指數(shù)(PI)、矢狀面垂軸(SVA)、脊柱骶骨角(SSA)、各椎體間終板夾角、胸腰椎轉(zhuǎn)折椎間隙(TLIP,胸椎后凸和腰椎前凸交界,椎體間終板夾角絕對值最接近0°的椎間隙)。統(tǒng)計學描述分析各測量參數(shù),Pearson correlation coefficient檢驗各參數(shù)間相關(guān)性。根據(jù)LL、TLIP將成人脊柱-骨盆矢狀面分為3型,Ⅰ型至Ⅲ型組間各參數(shù)分別進行多重比較。結(jié)果:年齡 37.22±10.77 歲(20～60 歲),身高 164.68±7.72cm(144～186cm),體重 60.83±10.83Kg(45～99 Kg)。TK36.03±7.34°(17.8～56.5°),TLK 6.40±7.43°(-12.85～23.43。),LL-48.75±10.03°(-68.6～-21.2°),SS 33.57±7.64°(14.07～52.18°),PT 11.18±6.59°(-3.93～31.75°),PI 44.75±9.01°(24.69°～70.52),SVA-2.66±22.79mm(-65.81～44.73mm),SSA 127.32±8.98°(106.25～153.92°),各椎體間終板夾角 L5S1-11.82±4.23°(-23.4～-2.3°),L4L5-12.13±3.01°(-18.51～-5.53°),L3/L4-6.46±2.33°(-13～0°),L2L3-3.51±2.18°(-9.92～1.29°),L1L2-1.53±1.97°(-7.94～2.51°),T12L10.25±1.59°(-5.51～4.81°),T11T12 1.64±1.44°(-3.83～5.59°),T10T112.2±0.99°(-2.3～5.56°),TLIP 為 L3/4 1 例、L2/3 18 例、L1/2 13 例、T12/L1 62 例、T11/12 17例。Pearson correlation coefficient檢驗僅LL與其它參數(shù)均有顯著相關(guān)性,LL 與 TK、PI、SS、SSA 呈負相關(guān),r 分別為-0.387、-0.536、-0.858、-0.801(P0.01),與 TLK、SVA、PT 呈正相關(guān),r 分別為 0.319、0.296、0.262(P0.01)。根據(jù)LL、TLIP將成人脊柱-骨盆矢狀面分為3型,Ⅰ型:LL-40°,TLIP為 L2/3 以下;Ⅱ型:-60°LL-40°,TLIP 為 L1/2 或 T12/L1;Ⅲ型:LL-60°,TLIP為T11/12以上。入選志愿者均可納入分型:Ⅰ型19例,Ⅱ型75例,Ⅲ型17例。分型間Multiple Comparisons LSD多重比較示LL、SS、SSA、PI組間兩兩比較P值均0.05。結(jié)論:成人脊柱-骨盆排列規(guī)律為腰椎前凸角小,常數(shù)PI小,胸腰段后凸,胸椎后凸小與胸腰段形成一長節(jié)段后凸,骶骨后傾,骶骨后上角向后遠離股骨頭,骨盆開口水平,軀干前傾,脊柱趨向正向失衡,反之亦然。LL在脊柱矢狀面平衡中占有核心地位。成人脊柱-骨盆矢狀面根據(jù)LL和TLIP可分為三型,該分型能較好反映脊柱骨盆矢狀面排列的差異與平衡。
[Abstract]:Objective: to measure the parameters of spinal column-pelvis loss plane in a volunteer population and to study its correlation. A new type of adult spine-pelvic sagittal plane was proposed based on lumbar kyphosis angle (LL) and thoracolumbar vertebrae intervertebral space (TLIP). Methods: a total length film of the spinal column was taken from 111 adult volunteers. The inclusion criteria were 1: 1, 20 to 60 years of age, with no history of spine and lower extremity osteoarthropathy, no history of long-term low back pain, no spinal deformity, and mild vertebral wedge degeneration as normal vertebral body variation. There were 56 women and 55 men. General parameters: age, weight, Height. X ray measurement parameters include: thoracic kyphosis angle (TK), thoracolumbar segment kyphosis angle (TLK), lumbar kyphosis angle (LL), sacral angle obliquity angle of (SS), pelvis obliquity angle (PT), pelvic index (PI), sagittal plane (SVA), spine sacrum angle (SSA), interbody endplate angle. Thoracolumbar intervertebral space (TLIP, thoracic kyphosis and lumbar kyphosis, the intervertebral interbody endplate angle is closest to the intervertebral space of 0 擄). The correlation between the parameters was analyzed by Pearson correlation coefficient test. According to LL,TLIP, the sagittal plane of adult spine and pelvis was divided into 3 types. 緇撴灉:騫撮緞 37.22鹵10.77 宀，

本文編號：2206049