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腰椎间盘突出症中脊柱骨盆参数的评估

Evaluation of spinopelvic parameters in lumbar prolapsed intervertebral disc.

作者信息

Poonia Apoorva, Lodha Sambhav, Sharma N C

机构信息

Department of Radiology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

出版信息

Indian J Radiol Imaging. 2020 Jul-Sep;30(3):253-262. doi: 10.4103/ijri.IJRI_49_20. Epub 2020 Oct 15.

Abstract

BACKGROUND

Sacro-pelvic morphology and orientation are usually described in terms of pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Orientation and morphology of pelvis can affect degenerative changes in the lumbar spine. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults.

MATERIAL AND METHODS

A hospital-based cross-sectional study with a total of 60 cases was done. Patients presenting with back or leg pain having prolapsed disc on magnetic resonance imaging (MRI) were included in the study. A standing X-ray of LS spine from dorso-lumbar junction to mid-thigh was taken. Various spinopelvic parameters were assessed from the scannogram using the software.

RESULTS

The mean age was 39.27 years. L5S1 was the most common level. Mean SS, PT, PI, and LL were 37.78°, 13.52°, 51.33°, and 41.01°. Disc pathologies at L1L2, L2L3, and L4L5 level showed a positive correlation with PT, PI, and LL. Disc pathology at the L5S1 level shows a positive correlation with PT and LL. A statistically significant correlation between SS and degenerative spondylolisthesis at L4L5 was found from data with = 0.023.

DISCUSSION

An increase in SS statistically significantly increases the chance of development of degenerative spondylolisthesis at L4L5. An increase in PT, PI, and LL will cause an increase in disc pathology at L1L2. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L2L3. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L4L5. An increase in PT and LL will cause an increase in disc pathology at L5S1.

CONCLUSION

Standing lateral view radiograph from dorso-lumbar junction to the mid-thigh is as good as standing whole spine radiograph for measurement of spinopelvic parameters. Degenerative spondylolisthesis at L4L5 has a statistically significant correlation with an increase in SS.

摘要

背景

骶骨盆形态和方向通常根据骨盆入射角(PI)、骨盆倾斜度(PT)和骶骨坡度(SS)来描述。骨盆的方向和形态会影响腰椎的退变。因此,我们在此研究了年轻成年人各种矢状位脊柱骨盆参数与椎间盘退变程度之间的关系。

材料与方法

进行了一项基于医院的横断面研究,共纳入60例患者。研究纳入磁共振成像(MRI)显示椎间盘突出且伴有腰背痛或腿痛的患者。拍摄从胸腰段交界处至大腿中部的腰椎正位X线片。使用软件从扫描图像中评估各种脊柱骨盆参数。

结果

平均年龄为39.27岁。L5S1是最常见的节段。平均SS、PT、PI和LL分别为37.78°、13.52°、51.33°和41.01°。L1L2、L2L3和L4L5节段的椎间盘病变与PT、PI和LL呈正相关。L5S1节段的椎间盘病变与PT和LL呈正相关。从数据中发现SS与L4L5节段的退变性腰椎滑脱之间存在统计学显著相关性(P = 0.023)。

讨论

SS增加在统计学上显著增加L4L5节段发生退变性腰椎滑脱的几率。PT、PI和LL增加会导致L1L2节段的椎间盘病变增加。SS、PT、PI和LL增加会导致L2L3节段的椎间盘病变增加。SS、PT、PI和LL增加会导致L4L5节段的椎间盘病变增加。PT和LL增加会导致L5S1节段的椎间盘病变增加。

结论

从胸腰段交界处至大腿中部的站立位侧位X线片在测量脊柱骨盆参数方面与站立位全脊柱X线片效果相当。L4L5节段的退变性腰椎滑脱与SS增加存在统计学显著相关性。

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