Department of Orthopaedic Surgery, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
Spine (Phila Pa 1976). 2012 Jan 1;37(1):E10-5. doi: 10.1097/BRS.0b013e3182257bb0.
An anatomic study of sacral inclination, pelvic incidence, pelvic lordosis, and disc degeneration in cadaveric lumbar spines.
To evaluate the relationship between sacropelvic parameters and disc degeneration in subjects with bilateral spondylolysis at L5.
L5-S1 disc degeneration is greater in patients with spondylolytic defects (L5-S1) than with an intact pars interarticularis secondary to the instability caused by spondylolysis. Sacral inclination, pelvic incidence, and pelvic lordosis affect sagittal balance and axial forces on the L5-S1 disc.
An observational study was performed on 120 cadaveric specimens with spondylolysis (L5-S1) identified of 3100 total cadaveric specimens. Nine specimens were excluded because of incomplete or degraded skeletal elements; 10 were excluded for having unilateral defects only. The specimens were evaluated for sacral inclination, pelvic incidence, and pelvic lordosis. Disc degeneration and facet arthrosis at L4-L5 and L5-S1 were measured by the classification of Eubanks et al. Linear regression analyses were then used to determine the relationship between sacropelvic parameters and degeneration at the L5-S1 segment, correcting for confounding factors such as age, sex, and race.
Linear regression demonstrated a significant association between sacral inclination and disc degeneration at L5-S1 (P = 0.018). Specimens were then divided into two groups, those in the highest quarter of pelvic incidence, and the remainder. Spearman rank correlation demonstrated a significant association between disc degeneration at L5-S1 and the highest quarter of pelvic incidence (P = 0.017). Increasing pelvic lordosis was also associated with an increase in facet arthrosis at L4-L5 (P = 0.006).
The findings of this study show a relationship between the sacropelvic geometry and the degree of L5-S1 disc degeneration as well as L4-L5 facet degeneration in spondylolytic specimens. This relationship may prove useful in predicting the course of disc degeneration in patients with spondylolysis.
对尸体腰椎的骶骨倾斜度、骨盆入射角、骨盆前倾角和椎间盘退变进行解剖学研究。
评估双侧峡部裂性 L5 脊柱裂患者的骶骨骨盆参数与椎间盘退变之间的关系。
与完整的关节突间峡部相比，L5-S1 椎间盘退变在有峡部裂缺陷的患者（L5-S1）中更为严重，这是由于峡部裂引起的不稳定性造成的。骶骨倾斜度、骨盆入射角和骨盆前倾角会影响 L5-S1 椎间盘的矢状平衡和轴向力。
对 3100 个尸体标本中的 120 个有峡部裂性 L5-S1 的尸体标本进行了一项观察性研究。由于骨骼元素不完整或退化，有 9 个标本被排除在外；有 10 个标本因仅有单侧缺陷而被排除在外。对这些标本进行了骶骨倾斜度、骨盆入射角和骨盆前倾角的评估。通过 Eubanks 等人的分类方法测量了 L4-L5 和 L5-S1 处的椎间盘退变和小关节关节炎。然后，使用线性回归分析来确定骶骨骨盆参数与 L5-S1 节段退变之间的关系，同时纠正年龄、性别和种族等混杂因素的影响。
线性回归显示，骶骨倾斜度与 L5-S1 椎间盘退变之间存在显著相关性（P = 0.018）。然后将标本分为两组，一组为骨盆入射角最高的四分之一，另一组为其余标本。Spearman 秩相关分析显示，L5-S1 椎间盘退变与骨盆入射角最高的四分之一之间存在显著相关性（P = 0.017）。骨盆前倾角增加也与 L4-L5 小关节关节炎的增加有关（P = 0.006）。
本研究的结果表明，在峡部裂性标本中，骶骨骨盆几何形状与 L5-S1 椎间盘退变程度以及 L4-L5 小关节退变之间存在关系。这种关系可能有助于预测峡部裂患者椎间盘退变的进程。
