Gussous Yazeed, Theologis Alexander A, Demb Joshua B, Tangtiphaiboontana Jennifer, Berven Sigurd
University of California-San Francisco, San Francisco, CA, USA.
Global Spine J. 2018 Feb;8(1):17-24. doi: 10.1177/2192568217696692. Epub 2017 May 31.
Secondary analysis of prospective, multicenter data.
To evaluate impact of sagittal parameters on health-related quality of life (HRQoL) in adults with lumbosacral spondylolisthesis.
Adults with unoperated lumbosacral spondylolisthesis were identified in the Spinal Deformity Study Group database. Pearson's correlations were calculated between SF-12 (Short Form-12)/Scoliosis Research Society-30 (SRS-30) scores and radiographic parameters (C7 sagittal vertical axis [SVA] deviation, T1 pelvic angle, pelvic tilt [PT], pelvic incidence, sacral slope, slip angle, Meyerding slip grade, Labelle classification). Main effects linear regression models measured association between individual health status measures and individual radiographic predictor variables.
Forty-five patients were analyzed (male, 15; female, 30; average age 40.5 ± 18.7 years; 14 low-grade, 31 high-grade). For low-grade slips, SVA had strong negative correlations with SF-12 mental component score (MCS), SRS-30 appearance, mental, and satisfaction domains ( = -0.57, = -0.60, = -0.58, = -0.53, respectively; < .05). For high-grade slips, slip angle had a moderate negative correlation with SF-12 MCS ( = -0.36; = .05) and SVA had strong negative correlations with SF-12 physical component score (PCS), SRS-30 appearance and activity domains ( = -0.48, = -0.48, = -0.45; < .05) and a moderate negative correlation with SRS-30 total ( = -0.37; < .05). T1 pelvic angle had a moderate negative correlation with SF-12 PCS and SRS-30 appearance ( = -0.37, = -0.36; ≤ .05). For every 1° increase in PT, there was a 0.04-point decrease in SRS appearance, 0.05-point decrease in SRS activity, 0.06-point decrease in SRS satisfaction, and 0.04-point decrease in SRS total score ( < .05).
Lumbosacral spondylolisthesis in adults negatively affects HRQoL. Multiple radiographic sagittal parameters negatively affect HRQoLs for patients with low- and high-grade slips. Improvement of sagittal parameters is an important goal of surgery for adults with lumbosacral spondylolisthesis.
对前瞻性多中心数据进行二次分析。
评估矢状面参数对腰骶部椎体滑脱成年患者健康相关生活质量（HRQoL）的影响。
在脊柱畸形研究组数据库中识别出未接受手术的腰骶部椎体滑脱成年患者。计算SF-12（简短健康调查问卷-12）/脊柱侧凸研究学会-30（SRS-30）评分与影像学参数（C7矢状面垂直轴[SVA]偏差、T1骨盆角、骨盆倾斜度[PT]、骨盆入射角、骶骨斜率、滑脱角、迈耶丁滑脱分级、拉贝尔分类）之间的Pearson相关性。主效应线性回归模型测量个体健康状况指标与个体影像学预测变量之间的关联。
共分析了45例患者（男性15例，女性30例；平均年龄40.5±18.7岁；14例低度滑脱，31例高度滑脱）。对于低度滑脱，SVA与SF-12心理成分评分（MCS）、SRS-30外观、心理和满意度领域呈强负相关（分别为r = -0.57，r = -0.60，r = -0.58，r = -0.53；P <.05）。对于高度滑脱，滑脱角与SF-12 MCS呈中度负相关（r = -0.36；P =.05），SVA与SF-12身体成分评分（PCS）、SRS-30外观和活动领域呈强负相关（r = -0.48，r = -0.48，r = -0.45；P <.05），与SRS-30总分呈中度负相关（r = -0.37；P <.05）。T1骨盆角与SF-12 PCS和SRS-30外观呈中度负相关（r = -0.37，r = -0.36；P≤.05）。PT每增加1°，SRS外观评分降低0.04分，SRS活动评分降低0.05分，SRS满意度评分降低0.06分，SRS总分降低0.04分（P <.05）。
成年腰骶部椎体滑脱对HRQoL有负面影响。多个影像学矢状面参数对低度和高度滑脱患者的HRQoL有负面影响。改善矢状面参数是成年腰骶部椎体滑脱患者手术的重要目标。
