Beck Joel, Brisby Helena, Baranto Adad, Westin Olof
Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, and Sahlgrenska University Hospital, Bruna Straket 11b, S-413 45, Gothenburg, Sweden.
J Exp Orthop. 2020 May 31;7(1):38. doi: 10.1186/s40634-020-00253-7.
The sagittal alignment of the lumbar spine and pelvis can be classified into several subtypes. It has been suggested that the risk of developing certain pathologies, such as a lumbar disc herniation (LDH) is affected by spinal sagittal profiles. The main aim of this study was to investigate the sagittal profile in young patients surgically treated for a lumbar disc herniation and if a discectomy would alter the sagittal parameters.
Sixteen active young patients (mean age 18.3 ± 3.2 SD) with a lumbar disc herniation having a discectomy were included. A classification according to Roussouly of the sagittal parameters was made by two senior spinal surgeons, both pre-operatively and post-operatively on radiographs. The distribution of sagittal parameters and spinopelvic profiles were analysed and compared to a previous established healthy normal population.
This series of active young patients with LDH exhibited a low lumbar lordosis dominance, with Roussouly sagittal profiles type 1 and type 2 accounting for more than 75% of the examined patients. An analysis of the erect radiographs revealed no significant changes in the post-operative sagittal profile.
This study showed that sagittal spinal alignment according to Roussouly in a young population with LDH is skewed compared with a normal population cohort. Furthermore, the lack of post-operative correction is suggestive of a non-ephemeral response to a LDH. Roussouly type 2 spinal sagittal profile may be a risk factor in young individuals suffering a disc herniation.
腰椎和骨盆的矢状位排列可分为几种亚型。有人提出,某些病理状况(如腰椎间盘突出症,LDH)的发生风险受脊柱矢状位形态的影响。本研究的主要目的是调查接受腰椎间盘突出症手术治疗的年轻患者的矢状位形态,以及椎间盘切除术是否会改变矢状位参数。
纳入16例因腰椎间盘突出症接受椎间盘切除术的活跃年轻患者(平均年龄18.3±3.2标准差)。由两位资深脊柱外科医生在术前和术后的X线片上根据Roussouly法对矢状位参数进行分类。分析矢状位参数和脊柱骨盆形态的分布,并与先前建立的健康正常人群进行比较。
这组患有LDH的活跃年轻患者表现出腰椎前凸优势较低,Roussouly矢状位形态1型和2型占检查患者的75%以上。对站立位X线片的分析显示,术后矢状位形态无显著变化。
本研究表明,与正常人群队列相比,患有LDH的年轻人群中根据Roussouly法测量的脊柱矢状位排列存在偏差。此外,术后缺乏矫正提示对LDH的反应不是短暂的。Roussouly 2型脊柱矢状位形态可能是年轻椎间盘突出症患者的一个危险因素。