Yoshihara Hiroyuki, Hasegawa Kazuhiro, Okamoto Masashi, Hatsushikano Shun, Watanabe Kei
Department of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203 USA.
Niigata Spine Surgery Center, Niigata City, Japan.
Orthop Traumatol Surg Res. 2018 Nov;104(7):1017-1023. doi: 10.1016/j.otsr.2018.07.009. Epub 2018 Aug 11.
To clarify the relationship between whole body sagittal radiographic parameters and health related quality of life (HRQOL) in patients with spinal disease, and further analyse such relationship based on the pelvic incidence (PI) value.
100 patients (mean age: 64.4 years, M/F=50/50) with lumbar degenerative disease or spinal deformity were prospectively investigated. Following oswestry disability index (ODI) and scoliosis research society score 22 (SRS-22) questionnaire, whole body sagittal x-ray parameters were measured using a slot-scanning 3D x-ray imager (EOS). Correlations between such radiographic parameters and ODI/SRS-22 scores were analysed. Then, patients were divided into three groups based on the PI value (PI≤45°, 45<PI≤60°, and 60<PI), and correlations between the significantly correlated parameters and ODI/SRS-22 scores were analysed for each PI group.
C2-7 lordosis, pelvic tilt (PT), pelvic incidence (PI), PI minus lumbar lordosis (PI-LL), sagittal vertical axis (SVA), full balance integrated index (FBI), and knee flexion angle (KneeFlex) had a significant correlation with ODI or SRS-22 scores. Among those parameters, PI and FBI showed a significant correlation with both ODI and SRS-22 scores. High PI (>60°) group showed a strong correlation (R>0.4) with both ODI and SRS-22 scores for PI-LL parameter.
PI and FBI showed a significant correlation with both ODI and SRS-22 scores. PI-LL mismatch was strongly correlated with disability in high PI patients. Our study results may indicate that it is important to pay attention to the PI value in addition to the spinopelvic relationship.
II, prospective study.
阐明脊柱疾病患者全身矢状面影像学参数与健康相关生活质量（HRQOL）之间的关系，并基于骨盆入射角（PI）值进一步分析这种关系。
对100例腰椎退行性疾病或脊柱畸形患者（平均年龄：64.4岁，男/女 = 50/50）进行前瞻性研究。在进行奥斯威斯残疾指数（ODI）和脊柱侧弯研究协会22项评分（SRS - 22）问卷调查后，使用狭缝扫描三维X线成像仪（EOS）测量全身矢状面X线参数。分析这些影像学参数与ODI/SRS - 22评分之间的相关性。然后，根据PI值将患者分为三组（PI≤45°、45＜PI≤60°和60＜PI），并分析每组中显著相关参数与ODI/SRS - 22评分之间的相关性。
C2 - 7前凸、骨盆倾斜（PT）、骨盆入射角（PI）、PI减去腰椎前凸（PI - LL）、矢状垂直轴（SVA）、完全平衡综合指数（FBI）和膝关节屈曲角度（KneeFlex）与ODI或SRS - 22评分有显著相关性。在这些参数中，PI和FBI与ODI和SRS - 22评分均有显著相关性。高PI（>60°）组中，PI - LL参数与ODI和SRS - 22评分均有较强相关性（R>0.4）。
PI和FBI与ODI和SRS - 22评分均有显著相关性。PI - LL不匹配与高PI患者的残疾密切相关。我们的研究结果可能表明，除了脊柱骨盆关系外，关注PI值也很重要。
II，前瞻性研究。
