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患有和不患有腰椎间盘突出症的中国老年人群矢状位脊柱形态是否存在差异?

Does the sagittal spinal profile differ between the elderly Chinese populations with and without lumbar disc herniation?

机构信息

Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Diseases, Beijing, China.

Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Diseases, Beijing, China.

出版信息

Asian J Surg. 2022 Dec;45(12):2719-2724. doi: 10.1016/j.asjsur.2022.03.020. Epub 2022 Mar 31.

Abstract

OBJECTIVE

To explore the characteristics of the sagittal spinopelvic profile in the elderly Chinese population with lumbar disc herniation (LDH) and to evaluate its influence on the severity, location and number of disc degeneration.

METHODS

A retrospective analysis was conducted on 212 elderly Chinese patients with LDH and 213 asymptomatic volunteers with matched age and sex. Sagittal spinopelvic parameters were measured on the full-length X-ray and the sagittal profiles were determined according to the Roussouly classification. The severity, location and number of lumbar disc degeneration were evaluated from the L12 to L5S1 discs on the MRI images.

RESULTS

There were no significant differences in BMI between the two groups. Patients with LDH were found to have significantly smaller TK, LL, and SS than those in the asymptomatic population (P < 0.05), while contradicting observations were obtained of PT and TPA (P < 0.05). In the LDH group, Roussouly type 1 and type 2 (50.4% and 28.7%, respectively) were predominant and the proportion of type 1 in the elderly LDH population was further increased compared to the younger LDH population. LDH population with Roussouly type 1 and 2 showed more caudal herniated locations and fewer herniated numbers than those with type 3 and 4.

CONCLUSION

The sagittal spinopelvic profile was significantly different between the elderly Chinese population with and without LDH. There were significant differences in the Roussouly distribution between the elderly and the younger groups and different Roussouly types have different effects on the lumbar disc degeneration patterns.

摘要

目的

探讨腰椎间盘突出症(LDH)老年中国人群矢状位脊柱骨盆特征,并评估其对椎间盘退变严重程度、位置和数量的影响。

方法

回顾性分析 212 例老年腰椎间盘突出症患者和 213 例年龄和性别相匹配的无症状志愿者。在全长 X 线片上测量矢状位脊柱骨盆参数,并根据 Roussouly 分类确定矢状位轮廓。在 MRI 图像上从 L12 到 L5S1 评估腰椎间盘退变的严重程度、位置和数量。

结果

两组间 BMI 无显著差异。与无症状人群相比,LDH 患者的 TK、LL 和 SS 明显较小(P < 0.05),而 PT 和 TPA 则相反(P < 0.05)。在 LDH 组中,Roussouly 1 型和 2 型(分别为 50.4%和 28.7%)占主导地位,老年 LDH 人群中 Roussouly 1 型的比例高于年轻 LDH 人群。与 Roussouly 3 型和 4 型相比,Roussouly 1 型和 2 型的 LDH 人群更易出现尾部椎间盘突出位置,且突出数量更少。

结论

老年 LDH 人群与无 LDH 人群的矢状位脊柱骨盆特征存在显著差异。老年组与年轻组之间 Roussouly 分布存在显著差异,不同 Roussouly 类型对腰椎间盘退变模式有不同影响。

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