Lee Han-Dong, Jeon Chang-Hoon, Won Suk-Hyeong, Chung Nam-Su
Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
J Orthop Trauma. 2017 Jul;31(7):e195-e199. doi: 10.1097/BOT.0000000000000821.
To examine how spinopelvic morphology changes after traumatic spinopelvic dissociation and whether these changes affect the sagittal balance of the spine.
Retrospective analysis.
Level I trauma center.
Thirty-nine consecutive patients who were diagnosed with traumatic spinopelvic dissociation and had a minimum 2-year radiological follow-up were included.
Nineteen patients underwent spinopelvic pedicle screw fixation, 11 patients underwent percutaneous iliosacral screw fixation, and 9 patients were treated conservatively.
The main outcome measurements are as follows: (1) injury morphology (injury type and kyphotic angulation) at the initial and follow-up visits; (2) sagittal vertical axis (SVA) at the 2-year follow-up; (3) spinopelvic parameters [pelvic incidence (PI), sacral slope, pelvic tilt, lumbar lordosis, and thoracic kyphosis] at the 2-year follow-up; and (4) bodily pain and Oswestry Disability Index at the 2-year follow-up.
There were 21 men and 18 women, with a mean age of 28.3 years (15-62 years). At the 2-year follow-up, the mean SVA was 5.4 ± 4.1 cm and the mean PI was 76.9 ± 24.6 degrees. Factors related to SVA after traumatic spinopelvic dissociation were PI (r = 0.441, P = 0.017), pelvic tilt (r = 0.387, P = 0.038), and injury type of complete displacement (r = 0.372, P = 0.047). The bodily pain and Oswestry Disability Index was significantly poorer in patients with SVA modifier "+" than in patients with SVA modifier "0."
Lumbosacral kyphosis after traumatic spinopelvic dissociation increases PI, which can affect the sagittal balance of the spine and clinical outcome. Restoration of lumbosacral orientation is important for preventing sagittal imbalance.
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
研究创伤性脊柱骨盆分离后脊柱骨盆形态如何变化，以及这些变化是否会影响脊柱矢状面平衡。
回顾性分析。
一级创伤中心。
纳入39例连续诊断为创伤性脊柱骨盆分离且有至少2年影像学随访资料的患者。
19例患者接受脊柱骨盆椎弓根螺钉固定，11例患者接受经皮髂骶螺钉固定，9例患者接受保守治疗。
主要观察指标如下：（1）初次就诊和随访时的损伤形态（损伤类型和后凸角度）；（2）2年随访时的矢状垂直轴（SVA）；（3）2年随访时的脊柱骨盆参数[骨盆入射角（PI）、骶骨倾斜度、骨盆倾斜度、腰椎前凸和胸椎后凸]；（4）2年随访时的身体疼痛和Oswestry功能障碍指数。
男性21例，女性18例，平均年龄28.3岁（15 - 62岁）。2年随访时，平均SVA为5.4±4.1 cm，平均PI为76.9±24.6度。创伤性脊柱骨盆分离后与SVA相关的因素有PI（r = 0.441，P = 0.017）、骨盆倾斜度（r = 0.387，P = 0.038）和完全移位损伤类型（r = 0.372，P = 0.047）。SVA修正值为“+”的患者身体疼痛和Oswestry功能障碍指数明显比SVA修正值为“0”的患者差。
创伤性脊柱骨盆分离后的腰骶部后凸增加了PI，这会影响脊柱矢状面平衡和临床结局。恢复腰骶部方向对于预防矢状面失衡很重要。
预后IV级。有关证据水平的完整描述，请参阅《作者须知》。
