成人矢状位脊柱-骨盆对线：和歌山脊柱研究
Sagittal spino-pelvic alignment in adults: The Wakayama Spine Study.
作者信息
Asai Yoshiki, Tsutsui Shunji, Oka Hiroyuki, Yoshimura Noriko, Hashizume Hiroshi, Yamada Hiroshi, Akune Toru, Muraki Shigeyuki, Matsudaira Ko, Kawaguchi Hiroshi, Nakamura Kozo, Tanaka Sakae, Yoshida Munehito
机构信息
Department of Orthopedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, Japan.
Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
出版信息
PLoS One. 2017 Jun 6;12(6):e0178697. doi: 10.1371/journal.pone.0178697. eCollection 2017.
OBJECTIVES
To establish the normal values of spino-pelvic alignment and to clarify the effect of age-related changes using large, community-based cohorts.
METHODS
In this study, data from 1461 participants (466 men, 995 women) were analyzed. On lateral standing radiographs, the following parameters were measured: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and C7 sagittal vertical axis (SVA). All values are expressed as the mean±standard deviation. The Spearman rank correlation coefficient was used to examine correlations between variables of spino-pelvic parameters. Finally, we analyzed the relationship between age and spino-pelvic parameters. Therefore, we entered values for the body mass index (BMI), SVA, TK, and PI-LL into a multiple regression model to adjust for potential confounding factors.
RESULTS
The SVA, TK, and PT increased with age, and LL decreased with age. Regarding sex differences, the TK was statistically significantly larger in men than in women, and LL, PT, and PI were statistically significantly smaller in men than in women. Correlation coefficients between the SVA and TK, between the SVA and PI-LL, and between TK and PI-LL were none, strong, and weak, respectively. Results of multiple regression analysis between age and spino-pelvic parameters showed that the standardized partial regression coefficients for the SVA, TK, and PI-LL were 0.17, 0.30, and 0.23, respectively, in men and 0.29, 0.32, and 0.23, respectively, in women.
CONCLUSIONS
We found that all parameters were significantly associated with age in men and women. The SVA, TK, and PT increased with age, and LL decreased with age. Results of multiple regression analysis also demonstrated that the SVA, TK, and PI-LL are related to age. Indeed, the PI-LL value increased with age. In this study, a more excessive PI-LL mismatch was shown, indicating an increased risk of spinal malalignment. Differences in the absolute values of spino-pelvic parameters in each sex were small yet statistically significant. Thus, further study should be performed to corroborate this finding.
目的
利用大型社区队列建立脊柱-骨盆对线的正常值，并阐明年龄相关变化的影响。
方法
在本研究中，分析了1461名参与者（466名男性，995名女性）的数据。在站立位侧位X线片上，测量以下参数：胸椎后凸（TK）、腰椎前凸（LL）、骨盆倾斜（PT）、骨盆入射角（PI）和C7矢状垂直轴（SVA）。所有值均表示为平均值±标准差。采用Spearman等级相关系数检验脊柱-骨盆参数变量之间的相关性。最后，我们分析了年龄与脊柱-骨盆参数之间的关系。因此，我们将体重指数（BMI）、SVA、TK和PI-LL的值纳入多元回归模型，以调整潜在的混杂因素。
结果
SVA、TK和PT随年龄增加而增加，LL随年龄增加而降低。关于性别差异，男性的TK在统计学上显著大于女性，男性的LL、PT和PI在统计学上显著小于女性。SVA与TK之间、SVA与PI-LL之间以及TK与PI-LL之间的相关系数分别为无、强和弱。年龄与脊柱-骨盆参数的多元回归分析结果显示，男性中SVA、TK和PI-LL的标准化偏回归系数分别为0.17、0.30和0.23，女性中分别为0.29、0.32和0.23。
结论
我们发现所有参数在男性和女性中均与年龄显著相关。SVA、TK和PT随年龄增加而增加，LL随年龄增加而降低。多元回归分析结果还表明，SVA、TK和PI-LL与年龄有关。事实上，PI-LL值随年龄增加而增加。在本研究中，显示出更多过度的PI-LL不匹配，表明脊柱排列不齐的风险增加。各性别脊柱-骨盆参数绝对值的差异较小但具有统计学意义。因此，应进行进一步研究以证实这一发现。
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