Liang Yan, Xu Shuai, Guo Chen, Mao Keya, Liu Haiying
Spinal Surgery, Peking University People's Hospital, Beijing, China.
The Chinese PLA General Hospital (301 Hospital), Beijing, China.
Front Mol Neurosci. 2022 Mar 22;15:847857. doi: 10.3389/fnmol.2022.847857. eCollection 2022.
To explore the relationship between different sagittal parameters and identify the fitting formula of spino-pelvic parameters in patients with degenerative kyphosis (DK).
Sagittal balance is increasingly recognized as a predictor of clinical outcomes in patients with DK, while the relationship between different sagittal parameters in patients with DK remains unidentified.
A retrospective study with 279 participants was conducted. There were 168 DK patients which were divided into a sagittal balance group (SB:52 cases) and sagittal imbalance (SIB:116 cases). Radiographic measurements included thoracolumbar kyphosis (TLK), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), and pelvic tilt (PT). The correlations were analyzed between different sagittal parameters.
There were significant differences between the SB and SIB groups in terms of TLK, LL, PI-LL, PT, SVA, sacral slope (SS), and TK. For patients with DK, the LL was correlated with PT and TK. The linear regression was LL = 22.76-0.28 × PT + 0.62 × TK. In the SB group, TK was the influencing factor for LL and the linear regression analysis showed that LL = 33.57 + 0.33 × TK. While in the SIB group, PT and TK were in synergistic effect with PI-LL, the linear regression analysis showed that LL = 22.76-0.28 × PT + 0.62 × TK.
From the present study, we can see that LL has a significant correlation with PT and TK in patients with DK, while in SB, the LL was only correlated with TK. Therefore, the correction of LL in a different group should be calculated to avoid the incidence of proximal junction kyphosis (PJK).
探讨退变性后凸畸形（DK）患者不同矢状面参数之间的关系，并确定脊柱-骨盆参数的拟合公式。
矢状面平衡越来越被认为是DK患者临床预后的预测指标，而DK患者不同矢状面参数之间的关系仍不明确。
对279名参与者进行回顾性研究。其中168例DK患者被分为矢状面平衡组（SB：52例）和矢状面失衡组（SIB：116例）。影像学测量包括胸腰段后凸（TLK）、腰椎前凸（LL）、胸椎后凸（TK）、骨盆入射角（PI）和骨盆倾斜角（PT）。分析不同矢状面参数之间的相关性。
SB组和SIB组在TLK、LL、PI-LL、PT、矢状面垂直轴（SVA）、骶骨倾斜角（SS）和TK方面存在显著差异。对于DK患者，LL与PT和TK相关。线性回归方程为LL = 22.76 - 0.28×PT + 0.62×TK。在SB组中，TK是LL的影响因素，线性回归分析显示LL = 33.57 + 0.33×TK。而在SIB组中，PT和TK与PI-LL存在协同作用，线性回归分析显示LL = 22.76 - 0.28×PT + 0.62×TK。
从本研究可以看出，DK患者中LL与PT和TK显著相关，而在SB组中，LL仅与TK相关。因此，应计算不同组中LL的矫正值，以避免近端交界性后凸（PJK）的发生。
