【摘要】：目的 :探討60歲以上脊柱畸形患者脊柱-骨盆矢狀面參數(shù)與生活質(zhì)量的相關(guān)性。方法 :2014年3月~2016年5月60歲以上存在脊柱側(cè)凸20°、矢狀面軀干偏移(sagittal vertical axis,SVA)5cm或骨盆傾斜角(pelvic tilt,PT)25°的脊柱畸形患者共43例被納入研究,男7例,女36例,年齡64.0±3.5歲(60.0~73.0歲),其中退變性脊柱側(cè)凸12例,退變性脊柱后凸畸形7例,退變性脊柱側(cè)后凸畸形12例,特發(fā)性脊柱側(cè)凸6例,特發(fā)性脊柱側(cè)后凸畸形1例,陳舊性脊柱骨折伴后凸畸形5例。使用Scoliosis Research Society(SRS)-22量表、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)量表以及背部和下肢疼痛視覺模擬評分(the visual analog scale,VAS)評估患者的生活質(zhì)量;在站立位全脊柱側(cè)位X線片上測量脊柱-骨盆矢狀面參數(shù),包括SVA、胸椎后凸角(thoracic kyphosis,TK)、腰椎前凸角(lumbar lordosis,LL)、骨盆入射角(pelvic incidence,PI)、PT、骶骨傾斜角(sacral slope,SS)和T1骨盆角(T1 pelvic angle,TPA)。計(jì)算PI減LL,即PI-LL值。采用Pearson相關(guān)性檢驗(yàn)分析脊柱-骨盆矢狀面參數(shù)與生活質(zhì)量的相關(guān)性。結(jié)果:SRS-22量表中功能狀態(tài)、疼痛、自我形象、心理狀況及亞總分分別為13.4±2.1分、17.3±2.7分、13.2±3.0分、15.7±11.8分及59.6±5.6分;ODI、背部及下肢疼痛VAS評分分別為(46.8±17.8)%、5.7±2.6分和3.9±3.0分。SVA、TK、LL、PI、PT、SS、TPA和PI-LL分別為6.5±6.2cm、12.7°±15.8°、-16.9°±17.2°、49.0°±12.3°、30.2°±11.6°、18.8°±10.6°、28.8°±14.4°和32.1°±17.8°。SVA和TPA與SRS-22量表中功能狀況、疼痛、自我形象、SRS-22亞總分、ODI及背部疼痛VAS評分顯著相關(guān)(r=-0.386、-0.375、-0.361、-0.410、0.445、0.389,P0.05;r=-0.403、-0.426、-0.466、-0.425、0.512、0.465,P0.05);LL、PT、PI-LL與ODI及背部疼痛VAS評分顯著相關(guān)(r=0.368、0.367,P0.05;r=0.376、0.341,P0.05;r=0.401、0.395,P0.05);TK、PI和SS與生活質(zhì)量各量表評分均無關(guān)(P0.05)。結(jié)論 :在60歲以上脊柱畸形患者中,TPA和SVA增大會增加患者功能障礙、腰背部疼痛程度并降低患者自我形象;LL減小、PT和PI-LL增大會加重患者腰背部疼痛程度。TPA能同時(shí)反映脊柱和骨盆矢狀面狀態(tài),和生活質(zhì)量相關(guān)性最強(qiáng)。
[Abstract]:Objective: to investigate the correlation between the sagittal plane parameters of spine and pelvis and quality of life in patients with spinal deformity over 60 years old. Methods: from March 2014 to May 2016, 43 patients (7 males and 36 females) with scoliosis 20 擄, sagittal trunk offset (sagittal vertical axis,SVA) 5cm or pelvic tilt angle (pelvic tilt,PT) 25 擄were included in the study. The age was 64.0 鹵3.5 years (60.073.0 years), including 12 degenerative scoliosis, 7 degenerative scoliosis, 12 degenerative scoliosis, 6 idiopathic scoliosis and 1 idiopathic scoliosis. 5 cases of old spinal fracture with kyphosis. The quality of life (QOL) was evaluated by Scoliosis Research Society (SRS) 22 (Oswestry disability index,ODI) and visual analogue score (the visual analog scale,VAS) of back and lower limb pain, and the sagittal parameters of spine and pelvis were measured on the standing position of the lateral spine. SVA, included thoracic kyphoid angle (thoracic kyphosis,TK), lumbar lordosis angle (lumbar lordosis,LL), pelvic incident angle (pelvic incidence,PI) PTT, sacral obliquity angle (sacral slope,SS) and T1 pelvic angle (T1 pelvic angle,TPA). Calculate PI minus LL, or PI-LL value. The correlation between sagittal parameters of spine and pelvis and quality of life was analyzed by Pearson correlation test. Results functional state, pain, self-image, 蹇冪悊鐘跺喌鍙?qiáng)浜氭�誨垎鍒嗗埆涓，

本文編號：2209962