Zhou Ziyu, Hou Caiyun, Li Dongdong, Si Jianwei
Department of Spine Surgery, Yulin City First Hospital Yulin Branch, No. 93, Yuxi Road, Yulin 719000, China.
Medical College of Yan'an University, No. 580, Shengdi Road, Yan'an 716000, China.
J Orthop Sci. 2018 Nov;23(6):902-907. doi: 10.1016/j.jos.2018.06.021. Epub 2018 Jul 25.
Degenerative spondylolisthesis (DS) and lumbar spinal stenosis (LSS) are the most common degenerative spinal diseases. The evaluating of spinopelvic sagittal alignment of the two diseases using pelvic radius (PR) technique have not been reported. The purpose of this study was to use PR measurement technique to compare the differences in spinopelvic sagittal alignment between DS and LSS.
A total of 145 patients with DS or LSS were retrospectively reviewed. Seventy patients with DS (DS group) and 75 age-matched patients with LSS (LSS group) were enrolled. Spinopelvic parameters including pelvic angle (PA), regional lumbopelvic lordosis (PR-L1, PR-L2, PR-L3, PR-L4 and PR-L5), total lumbopelvic lordosis (PR-T12), pelvic morphology (PR-S1), sagittal vertical axis from the C7 plumb line (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), L4 slope and L5 slope were assessed in the two groups. Several parameters of DS and LSS group were compared with the normal population (NP).
The PR-L4, PR-L5 and PR-S1 in the DS group were significantly smaller than those in the LSS group. There was no difference in PR-T12 between the DS group and NP (p > 0.05), while PR-T12 of the LSS group were significantly lower (p < 0.01). Degree of correlations among spinopelvic parameters differed between the two groups. PR-T12 of the DS group was more strongly correlated with PA (r = -0.829, p < 0.001) than with LL (r = 0.664, p < 0.001), TK (r = 0.582, p < 0.001). PR-T12 of the LSS group was more strongly correlated with LL (r = 0.854, p < 0.001), TK (r = 0.616, p < 0.001) than with PA (r = -0.582, p < 0.001).
PR-L4 and PR-L5 may be the predisposing factors for DS development. Spinopelvic morphology differed in patients with DS and LSS compared to NP. The compensatory mechanisms to maintain spinopelvic sagittal alignment in DS and LSS patients may be different.
退变性腰椎滑脱（DS）和腰椎管狭窄症（LSS）是最常见的脊柱退变性疾病。尚未有关于使用骨盆半径（PR）技术评估这两种疾病的脊柱骨盆矢状位对线情况的报道。本研究的目的是使用PR测量技术比较DS和LSS患者脊柱骨盆矢状位对线的差异。
回顾性分析145例DS或LSS患者。纳入70例DS患者（DS组）和75例年龄匹配的LSS患者（LSS组）。评估两组患者的脊柱骨盆参数，包括骨盆角（PA）、局部腰骨盆前凸（PR-L1、PR-L2、PR-L3、PR-L4和PR-L5）、总腰骨盆前凸（PR-T12）、骨盆形态（PR-S1）、C7铅垂线矢状垂直轴（SVA）、腰椎前凸（LL）、胸椎后凸（TK）、L4倾斜度和L5倾斜度。将DS组和LSS组的几个参数与正常人群（NP）进行比较。
DS组的PR-L4、PR-L5和PR-S1明显小于LSS组。DS组与NP组的PR-T12无差异（p>0.05），而LSS组的PR-T12明显更低（p<0.01）。两组脊柱骨盆参数之间的相关性程度不同。DS组的PR-T12与PA的相关性更强（r=-0.829，p<0.001），而与LL（r=0.664，p<0.001）、TK（r=0.582，p<0.001）的相关性较弱。LSS组的PR-T12与LL（r=0.854，p<0.001）、TK（r=0.616，p<0.001）的相关性比与PA（r=-0.582，p<0.001）更强。
PR-L4和PR-L5可能是DS发生的易感因素。与NP相比，DS和LSS患者的脊柱骨盆形态不同。DS和LSS患者维持脊柱骨盆矢状位对线的代偿机制可能不同。
