老年无症状个体的颅盆对线：671个颅骨重心分析
Craniopelvic alignment in elderly asymptomatic individuals: analysis of 671 cranial centers of gravity.
作者信息
Yoshida Go, Yasuda Tatsuya, Togawa Daisuke, Hasegawa Tomohiko, Yamato Yu, Kobayashi Sho, Arima Hideyuki, Hoshino Hironobu, Matsuyama Yukihiro
机构信息
*Department of Orthopedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan; and †Department of Orthopedic Surgery, Hamamatsu Medical University, Hamamatsu, Japan.
出版信息
Spine (Phila Pa 1976). 2014 Jun 15;39(14):1121-7. doi: 10.1097/BRS.0000000000000360.
STUDY DESIGN
Prospective radiographical analysis using the cranial center of gravity (CCG) of sagittal vertical axis (SVA) in elderly asymptomatic individuals.
OBJECTIVE
To determine sex differences and age-related correlations of CCG and relationships between CCG and other spinopelvic parameters/health-related quality of life (HRQOL) measures.
SUMMARY OF BACKGROUND DATA
Few studies have investigated CCG in a relatively large sample of elderly asymptomatic individuals.
METHODS
Six hundred seventy-one healthy participants older than 50 years (mean age, 72.9 yr; range, 50-92 yr) were enrolled. Whole-spine standing radiographs were obtained. The following radiographical measurements were obtained: (1) CCG-C7 SVA, (2) C7-SVA, (3) CCG-SVA, (4) C2-C7 lordosis angle, (5) thoracic kyphosis, (6) lumbar lordosis, (7) pelvic incidence, and (8) sacral slope. HRQOL measures included the EuroQol-5D and Oswestry Disability Index. Pearson product-moment correlation coefficients were calculated between pairs of radiographical measures and HRQOL.
RESULTS
Sex differences were observed in CCG-C7 SVA, CCG-SVA, C2-C7 Cobb angle, thoracic kyphosis, and pelvic incidence. Three SVA parameters (CCG-C7 SVA, C7-SVA, CCG-SVA) rapidly increased between seventh and ninth decades and were approximately 40, 80, and 120 mm, respectively, in the ninth decade. Age-related correlations were observed for all parameters without pelvic incidence, and the CCG measurement correlated the most with age. Furthermore, CCG-SVA correlated with other spinopelvic measurements and HRQOL.
CONCLUSION
Age-related changes and sex difference in craniopelvic alignment were analyzed. Craniopelvic alignment became rapidly positive with age, particularly in the eighth decade. The CCG measurement correlated the most with age and may be a useful index marker of global spinal balance in decision making for surgical treatment of adult deformity involving cervical and thoracolumbar lesions.
LEVEL OF EVIDENCE
研究设计
对老年无症状个体使用矢状垂直轴（SVA）的颅重心（CCG）进行前瞻性影像学分析。
目的
确定CCG的性别差异和年龄相关性，以及CCG与其他脊柱骨盆参数/健康相关生活质量（HRQOL）指标之间的关系。
背景数据总结
很少有研究在相对较大样本的老年无症状个体中调查CCG。
方法
纳入671名年龄超过50岁（平均年龄72.9岁；范围50 - 92岁）的健康参与者。获取全脊柱站立位X线片。进行以下影像学测量：（1）CCG - C7 SVA，（2）C7 - SVA，（3）CCG - SVA，（4）C2 - C7前凸角，（5）胸椎后凸，（6）腰椎前凸，（7）骨盆入射角，（8）骶骨倾斜度。HRQOL指标包括欧洲五维健康量表（EuroQol - 5D）和奥斯维斯特残疾指数（Oswestry Disability Index）。计算成对的影像学测量指标与HRQOL之间的Pearson积矩相关系数。
结果
在CCG - C7 SVA、CCG - SVA、C2 - C7 Cobb角、胸椎后凸和骨盆入射角方面观察到性别差异。三个SVA参数（CCG - C7 SVA、C7 - SVA、CCG - SVA）在第七和第九个十年间迅速增加，在第九个十年分别约为40、80和120毫米。观察到所有无骨盆入射角参数与年龄相关的相关性，且CCG测量值与年龄的相关性最强。此外，CCG - SVA与其他脊柱骨盆测量指标和HRQOL相关。
结论
分析了颅骨盆对线的年龄相关变化和性别差异。颅骨盆对线随年龄迅速变为正值，尤其是在第八个十年。CCG测量值与年龄的相关性最强，可能是涉及颈椎和胸腰椎病变的成人畸形手术治疗决策中全球脊柱平衡的有用指标。
证据水平
4级
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