Nisantasi University, Department of Orthopaedics and Traumatology, Bhtclinic İstanbul Tema Hastanesi, Orthopedics And Traumatology, Atakent Mh 4.Cadde No 36 PC 34307, Kucukcekmece/Istanbul, Turkey.
Bursa City Hospital, Orthopedics and Traumatology, Bursa, Turkey.
Neurochirurgie. 2023 Jan;69(1):101388. doi: 10.1016/j.neuchi.2022.101388. Epub 2022 Dec 9.
This study aims to find out if there is any relationship between disc pathology and spinopelvic morphology, respectively.
A total of 152 patients who complained about low back pain were assessed retrospectively. Patients were divided into three groups based on the presence of disc pathology: non-degenerative (ND) (n=34), degenerative disc disease (DDD) (n=80), and lumbar disc herniation (LDH) (n=38). Spinopelvic parameters were measured on the lateral standing radiographs using Surgimap® Software. The degree of degeneration of each disc was evaluated using T2-weighted images according to the Pfirmann classification. Correlation analyses were performed.
No significant difference was observed between the three groups in terms of sagittal spinal and pelvic parameters. Age and BMI were positively correlated with DDD and LDH. PI and proximal lombar lordosis (PLL) were the only effective variables in predicting DDD. PT and distal lumbar lordosis (DLL) were found to be effective variables in predicting LDH. PI and PT values in patients with L1, L2, and L3 DDD were statistically significantly higher than those without degeneration (P<0.05). Although there were no statistical differences between PI and PT values (P>0.05), DLL values in L4 and L5 DDD patients were significantly lower than those without degeneration (P=0.041; P=0.046; P<0.05).
The sagittal morphology of the spine directly influences the extent of lumbar disc degeneration. As the values of PI and PT increase, disc degeneration tends to occur at higher levels (L1-2-3). Disc degeneration at lower levels (L4-5) was associated with low DLL levels.
Level III, retrospective study.
本研究旨在分别探讨椎间盘病变与脊柱骨盆形态之间的关系。
回顾性评估了 152 例腰痛患者。根据椎间盘病变的存在情况，患者分为三组：非退行性（ND）（n=34）、退行性椎间盘疾病（DDD）（n=80）和腰椎间盘突出症（LDH）（n=38）。使用 Surgimap®软件在侧位站立位 X 线片上测量脊柱骨盆参数。根据 Pfirrmann 分级，使用 T2 加权图像评估每个椎间盘的退变程度。进行了相关性分析。
三组间矢状位脊柱和骨盆参数无显著差异。年龄和 BMI 与 DDD 和 LDH 呈正相关。PI 和近端腰椎前凸（PLL）是预测 DDD 的唯一有效变量。PT 和远端腰椎前凸（DLL）是预测 LDH 的有效变量。DDD 患者的 L1、L2 和 L3 部位的 PI 和 PT 值明显高于无退变患者（P<0.05）。尽管 PI 和 PT 值之间无统计学差异（P>0.05），但 DDD 患者的 L4 和 L5 部位的 DLL 值明显低于无退变患者（P=0.041；P=0.046；P<0.05）。
脊柱矢状形态直接影响腰椎间盘退变的程度。随着 PI 和 PT 值的增加，椎间盘退变倾向于发生在更高的水平（L1-2-3）。较低水平（L4-5）的椎间盘退变与较低的 DLL 水平有关。
III 级，回顾性研究。
