Hresko M Timothy, Deckey David G, Hinchcliff Emily, Kalish Leslie A
Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA; Tufts Medical School, 145 Harrison Avenue, Boston, MA 02111, USA.
Spine Deform. 2019 Nov;7(6):945-949. doi: 10.1016/j.jspd.2019.03.008.
Retrospective comparative case series.
Evaluation of sacral morphology in spondylolisthesis patients compared with asymptomatic controls.
Patients with spondylolisthesis are known to differ from asymptomatic controls in sagittal plane anatomy, but few studies examine the coronal and axial plane differences in these cohorts.
This is a retrospective evaluation of magnetic resonance imaging of the lumbosacral spine in 29 spondylolisthesis patients and an asymptomatic cohort (n = 154). Measurements of the linear distance and angular position of L5 and sacrum were performed in the sagittal, coronal, and axial planes. Receiver operating characteristic (ROC) curve analysis quantified these associations. High- and low-grade spondylolisthesis patients were compared with two-sample t-tests. All p-values are two-sided and considered significant when p < .05.
Axial measurements showed the distance of the right to left anterior ala and the L5 body width did not differ between the cohorts. Sacroiliac (SI) joint angles in the spondylolisthesis cohort were closer to the true sagittal plane than in the controls 109° versus 121° (p < .001). In the sagittal plane, the linear measurement of the ratio of the midpoint anteroposterior width L5 to the sacral end plate was larger in the high-grade patients than the low-grade patients and controls. In addition, the kyphosis between S1-S2 and S2-S3 was larger in the spondylolisthesis cohort.
The SI joints in patients with spondylolisthesis were orientated closer to the sagittal plane than in the controls. An awareness of this positioning may be important in surgical implant insertion as well as rehabilitation of hip extensor weakness. The main anatomical differences found in this study were in the sagittal plane. Sacral end plate abnormalities were well visualized and consistent with radiographic findings in the literature.
Level III, diagnostic.
回顾性比较病例系列。
与无症状对照组相比，评估腰椎滑脱症患者的骶骨形态。
已知腰椎滑脱症患者在矢状面解剖结构上与无症状对照组不同，但很少有研究探讨这些队列在冠状面和轴平面上的差异。
这是一项对29例腰椎滑脱症患者和一个无症状队列（n = 154）的腰骶部脊柱磁共振成像的回顾性评估。在矢状面、冠状面和轴平面上测量L5和骶骨的线性距离和角位置。采用受试者操作特征（ROC）曲线分析对这些关联进行量化。采用两样本t检验比较高、低度腰椎滑脱症患者。所有p值均为双侧，当p <.05时被认为具有统计学意义。
轴平面测量显示，两组队列之间右至左前翼的距离和L5椎体宽度无差异。腰椎滑脱症队列中的骶髂（SI）关节角度比对照组更接近真正的矢状面，分别为109°和121°（p <.001）。在矢状面，高度患者L5中点前后宽度与骶骨终板的线性测量比值大于低度患者和对照组。此外，腰椎滑脱症队列中S1 - S2和S2 - S3之间的后凸更大。
腰椎滑脱症患者的SI关节比对照组更靠近矢状面。了解这种定位在手术植入物插入以及髋伸肌无力的康复中可能很重要。本研究发现的主要解剖学差异在矢状面。骶骨终板异常清晰可见，与文献中的影像学结果一致。
III级，诊断性。
