双平面槽式扫描全身立体摄影术分析 291 例健康志愿者腰骶移行椎对脊柱骨盆参数的影响。
Influence of lumbosacral transitional vertebrae on spinopelvic parameters using biplanar slot scanning full body stereoradiography-analysis of 291 healthy volunteers.
机构信息
Niigata Spine Surgery Center, Japan; Dept. of Radiological Technology, School of Health Science, Niigata University, Japan.
Niigata Spine Surgery Center, Japan.
出版信息
J Orthop Sci. 2022 Jul;27(4):751-759. doi: 10.1016/j.jos.2021.03.009. Epub 2021 May 6.
BACKGROUND
Proper identification of lumbosacral transitional vertebrae (LSTV) is important to characterize the relationship between the transitional segment and adjacent levels. Classical classification schemes are inaccurate with respect to the whole spine. We propose a precise vertebral numbering method and investigated the relationship between LSTV and whole-body sagittal alignment.
METHODS
A total of 291 healthy adult volunteers with no history of spinal disease were evaluated with biplanar slot scanning full body stereoradiography to determine the prevalence of LSTV. Vertebrae were counted from the first cervical vertebra using both coronal and sagittal plane images. We then investigated the influence of LSTV on whole-body sagittal alignment in 279 participants. Whole-body key parameters descriptive statistics were compared among groups according to the number of vertebrae (L4, L5, and L6). Statistical analysis was performed between normal and LSTV cases using the Steel-Dwass analysis.
RESULTS
Of the 291 subjects, 14 (4.8%) had 23 vertebrae and 16 (5.5%) had 25 vertebrae. Eleven (3.8%) had Th11, 3 (1.0%) had L4, and 1 (0.3%) had Th11 + L6, 16 (5.5%) had L6. Compared with the normal group, the sacral base in relation to the pelvis was higher in the L4 group and lower in the L6 group. The C2-C7 angle and lumbar lordosis (LL) were increased in both the L4 and L6 groups. All remaining parameters were decreased in the L4 group and increased in the L6 group. The relationship between LL and PI was similar in the normal and LSTV groups, despite the difference in the sacral base location.
CONCLUSIONS
We propose a precise method for numbering the vertebrae using coronal and sagittal full body images. The spinopelvic parameters of the LSTV population significantly differed from those in the normal spine population due to differences in the sacral base location.
背景
正确识别腰骶移行椎（LSTV）对于描述移行节段与相邻节段的关系非常重要。经典的分类方案对整个脊柱并不准确。我们提出了一种精确的椎体编号方法，并研究了 LSTV 与全身矢状面排列的关系。
方法
共评估了 291 名无脊柱疾病病史的健康成年志愿者，使用双平面槽式全身立体摄影术进行双平面断层扫描，以确定 LSTV 的患病率。使用冠状面和矢状面图像从第一颈椎开始计数椎体。然后，我们在 279 名参与者中研究了 LSTV 对全身矢状面排列的影响。根据椎体数量（L4、L5 和 L6），对各组的全身关键参数描述性统计数据进行比较。使用 Steel-Dwass 分析在正常组和 LSTV 病例之间进行统计分析。
结果
在 291 名受试者中，有 14 名（4.8%）有 23 个椎体，有 16 名（5.5%）有 25 个椎体。11 名（3.8%）有 Th11，3 名（1.0%）有 L4，1 名（0.3%）有 Th11+L6，16 名（5.5%）有 L6。与正常组相比，L4 组骨盆与骶骨基底部的关系更高，L6 组更低。C2-C7 角和腰椎前凸（LL）在 L4 和 L6 组均增加。L4 组所有其他参数减少，L6 组所有参数增加。尽管骶骨基底部位置不同，但 LSTV 组和正常组的 LL 与 PI 之间的关系相似。
结论
我们提出了一种使用冠状面和矢状面全身图像对椎体进行编号的精确方法。由于骶骨基底部位置的不同，LSTV 人群的脊柱骨盆参数与正常脊柱人群明显不同。
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