Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany.
Department of Radiology, Ludwig-Maximilian-University Hospital Marchioninistraße, Munich, Germany.
PLoS One. 2021 Jun 9;16(6):e0252385. doi: 10.1371/journal.pone.0252385. eCollection 2021.
This study aims to investigate the correlation between spinopelvic parameters in supine position (pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL)), disc degeneration and herniation of the thoracolumbar spine, as well as cardiovascular risk factors and back pain in a southern German cohort from the general population.
This study is a cross-sectional, case-control study drawn from a prospective cohort of the "Cooperative Health Research in the Region of Augsburg/Kooperative Gesundheitsforschung in der Region Augsburg" study (KORA). In total, 374 participants (mean age 56.4 ± 9.2 years; 57.8% male) from the whole-body MRI cohort (FF4) were included. All participants underwent a standardized whole-body MRI on which disc degeneration of the thoracic and lumbar spine was evaluated using a sequence adapted Pfirrmann score. PI, PT, SS and LL were measured according to the description in the literature, using sagittal imaging. Furthermore, disc bulging and protrusion were assessed. Correlations were estimated by logistic regression models providing odds ratios.
Mean PI was 54.0° ± 11.1°, PT 13.0° ± 5.8°, SS 40.2° ± 8.8° and LL 36.2° ± 9.6°. SS was greater in men (p<0.05) and lumbar lordosis in women (p<0.001). PT increased by 0.09° per age-year with rising age. Age was not associated with PI, SS and LL. Neither BMI, hypertension, cholesterol, lipid levels, nor physical activity were associated with PI, PT, SS or LL. Diabetes mellitus negatively correlated with SS (β = -4.19; 95%CI -7.31-1.06, p<0.01). Smaller spinopelvic parameters (PI, SS and LL) where significantly (p<0.05) correlated with an increased frequency of disc bulging, as well as a local clustering in the lumbar, but not the thoracic spine.
In conclusion, spinopelvic parameters, measured in supine position, are significantly correlated with disc bulging alone; there is no significant correlation between supine spinopelvic parameters and disc degeneration, back pain or cardiovascular risk factors.
本研究旨在探讨仰卧位脊柱骨盆参数（骨盆入射角（PI）、骶骨倾斜角（SS）、骨盆倾斜角（PT）、腰椎前凸角（LL））与胸腰椎椎间盘退变和突出、心血管危险因素以及背痛之间的相关性，该研究队列来自德国南部的一般人群。
这是一项来自前瞻性“奥格斯堡合作健康研究/Cooperative Gesundheitsforschung in der Region Augsburg（KORA）”队列的横断面病例对照研究。总共纳入了来自全身 MRI 队列（FF4）的 374 名参与者（平均年龄 56.4 ± 9.2 岁；57.8%为男性）。所有参与者均接受了全身 MRI 检查，使用改良 Pfirrmann 评分评估胸腰椎椎间盘退变。根据文献描述，使用矢状位成像测量 PI、PT、SS 和 LL。此外，还评估了椎间盘膨出和突出。通过提供比值比的逻辑回归模型估计相关性。
平均 PI 为 54.0°±11.1°，PT 为 13.0°±5.8°，SS 为 40.2°±8.8°，LL 为 36.2°±9.6°。男性 SS 较大（p<0.05），女性腰椎前凸较大（p<0.001）。PT 随年龄增长每年增加 0.09°。年龄与 PI、SS 和 LL 无关。BMI、高血压、胆固醇、血脂水平和体力活动均与 PI、PT、SS 或 LL 无关。糖尿病与 SS 呈负相关（β=-4.19；95%CI-7.31-1.06，p<0.01）。较小的脊柱骨盆参数（PI、SS 和 LL）与椎间盘膨出的频率增加显著相关（p<0.05），并且在腰椎但不在胸椎局部聚集。
综上所述，仰卧位测量的脊柱骨盆参数与椎间盘膨出显著相关；仰卧位脊柱骨盆参数与椎间盘退变、背痛或心血管危险因素之间无显著相关性。
