Agrawal Anubhav, Abayazeed Aly, Francis Sean L, Tolentino Jocelyn, Ostergard Donald R, Seow Albert, Van Bogaert Eric, Rose Timothy, Deveneau Nicolette E, Azadi Ali
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of OB/GYN, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA,
Int Urogynecol J. 2015 Jun;26(6):887-91. doi: 10.1007/s00192-014-2621-5. Epub 2015 Jan 30.
Pelvic floor disorders are becoming more prevalent in the elderly population. Since more patients are seeking definitive management for their prolapse, the number of elderly patients undergoing sacral colpopexies will likely increase. During sacral colpopexies, the surgeon must carefully dissect in the presacral space and avoid vital structures. In elderly patients the aorta potentially elongates and the vertebral body height decreases. Consequently, there is a potential for anatomical change of distance from the bifurcation of the aorta to the sacral promontory. This study aimed to correlate the aorta-sacral promontory distance with age.
From 1 January 2013 to 31 January 2014 computed tomography (CT) images of 241 patients were reviewed in this retrospective study. Radiologists measured the aorta-sacral promontory distance on sagittal acquisition. The corresponding demographic information of age, body mass index, and comorbidities was evaluated using univariate analysis and univariate linear regression.
The mean age was 56.6 years, and BMI was 27.6. The mean aorta-sacral promontory measurement based on the CT scan was 63.11 mm. Univariate analysis using a t test and ANOVA demonstrated an inverse correlation with age (p < 0.0001) and hypertension (p = 0.0034) and a positive correlation with BMI categories (p < 0.0017) Under univariate linear regression, the weight of the patient in kilograms demonstrated positive correlation (p = 0.0413).
Based on CT measurements, the aorta-sacral promontory distance is decreased in elderly and hypertensive patients. Heavier patients have an increased aorta-sacral promontory distance. These potential anatomical variants should be considered before operating in the presacral space.
盆腔脏器脱垂在老年人群中愈发普遍。由于越来越多的患者寻求对其脱垂进行确定性治疗，接受骶骨阴道固定术的老年患者数量可能会增加。在骶骨阴道固定术中，外科医生必须在骶前间隙仔细解剖并避开重要结构。在老年患者中，主动脉可能会延长，椎体高度会降低。因此，从主动脉分叉到骶岬的距离存在解剖结构改变的可能性。本研究旨在将主动脉 - 骶岬距离与年龄进行关联。
在这项回顾性研究中，对2013年1月1日至2014年1月31日期间241例患者的计算机断层扫描（CT）图像进行了审查。放射科医生在矢状位图像上测量主动脉 - 骶岬距离。使用单因素分析和单因素线性回归评估年龄、体重指数和合并症等相应的人口统计学信息。
平均年龄为56.6岁，体重指数为27.6。基于CT扫描的主动脉 - 骶岬平均测量值为63.11毫米。使用t检验和方差分析的单因素分析显示与年龄呈负相关（p < 0.0001）和与高血压呈负相关（p = 0.0034），与体重指数类别呈正相关（p < 0.0017）。在单因素线性回归中，患者以千克为单位的体重呈正相关（p = 0.0413）。
基于CT测量，老年患者和高血压患者的主动脉 - 骶岬距离减小。体重较重的患者主动脉 - 骶岬距离增加。在骶前间隙进行手术前应考虑这些潜在的解剖变异。
