Wang Hai-Ying, Lyu Bing, Li Hui, Wang Shun-Yi
The First Department of Orthopaedics, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China.
Zhongguo Gu Shang. 2021 Jul 25;34(11):1016-9. doi: 10.12200/j.issn.1003-0034.2021.11.006.
To investigate the effect and correlation of spinopelvic sagittal parameters and facet joint angle on degenerative lumbar spondylolisthesis.
From July 2016 to September 2019, a total of 120 patients with L-L single segment degenerative spondylolisthesis were selected as observation objects (spondylolisthesis group), and 120 patients with L-L single-segment degenerative spinal stenosis matched by gender and age were selected as the control group. The following parameters were measured by imaging data:pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), L-L cephalic facet joint angle, caudal facet joint angle and facet asymmetry.The differences of parameters between the two groups were compared and the meaningful parameters were analyzed by Logistic regression. The correlations between facet joint direction and spinopelvic parameters in patients with degenerative lumbar spondylolisthesis were analyzed.
There were significant differences in PI, PT, LL, SVA, cephalic facet angle and caudal facet angle between two groups (P<0.05). Logistic regression analysis showed that PI, PT and cephalic facet joint angle were the risk factors for lumbar spondylolisthesis (P<0.05). The sagittal of the cephalic facet joint in spondylolisthesis group was significantly correlated with PI and PT(P<0.05).
High PI, PT and sagittal of cephalic facet joint are the risk factors for lumbar spondylolisthesis, and the sagittal degree of facet joints is closely related to high PI and PT.
探讨脊柱骨盆矢状面参数及小关节角度对退变性腰椎滑脱的影响及相关性。
选取2016年7月至2019年9月期间120例L₄-L₅单节段退变性腰椎滑脱患者作为观察组（腰椎滑脱组），选取120例年龄、性别相匹配的L₄-L₅单节段退变性腰椎管狭窄症患者作为对照组。通过影像资料测量以下参数：骨盆入射角（PI）、骨盆倾斜角（PT）、骶骨倾斜角（SS）、腰椎前凸角（LL）、胸椎后凸角（TK）、矢状垂直轴（SVA）、L₄-L₅上位小关节角度、下位小关节角度及小关节不对称性。比较两组参数差异，对有意义的参数进行Logistic回归分析。分析退变性腰椎滑脱患者小关节方向与脊柱骨盆参数之间的相关性。
两组PI、PT、LL、SVA、上位小关节角及下位小关节角比较差异有统计学意义（P<0.05）。Logistic回归分析显示PI、PT及上位小关节角是腰椎滑脱的危险因素（P<0.05）。腰椎滑脱组上位小关节矢状面与PI、PT显著相关（P<0.05）。
高PI、PT及上位小关节矢状面是腰椎滑脱的危险因素，小关节矢状面程度与高PI、PT密切相关。
