Department of Spinal Surgery, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China.
Department of Spinal Surgery, Xuzhou Central Hospital, Xuzhou, China.
Clin Anat. 2023 May;36(4):624-630. doi: 10.1002/ca.24006. Epub 2023 Jan 31.
The current study aimed to investigate the sagittal morphology of the spinopelvic complex and the components of the lumbar spine in the normal population. In total, 132 adult volunteers were retrospectively evaluated and divided into four groups according to the Roussouly classification. Statistical analysis of radiological parameters, including lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), PI-LL, LL-TK, lumbar vertebral lordosis from L1 to L5 (L1L-L5L), the intervertebral angle from L1-L2 to L5-S1 (IVA1-2-IVA5-1), segmental lordosis from L1 to L5 (S1L-S5L), the proportion of L1-L5 (L1%-L5%), the proportion of the intervertebral angle from L1-L2 to L5-S1 (IVA1-2%-IVA5-1%), and proportion of segmental lordosis from L1 to L5 (S1L%-S5L%), was performed. Based on the classification, type II (n = 46) was the most common, followed by type I (n = 39), type III (n = 36), and type IV (n = 11). The quantitative values of the sagittal parameters of the four groups were obtained. Results showed a significant difference in terms of LL, PI, SS, and LL-TK. Further, L1%, L2%, L3%, IVA1-2%, IVA2-3%, S1L%, S2L%, and S3L% had an increasing trend. PI was positively correlated with LL, S1L, S2L, S3L, S4L, S1L%, and S2L%, but not with S5L%. In conclusion, pelvic parameters had a significant effect on lumbar curvature and lordosis distribution. Further, the abovementioned results were beneficial for individual surgical decision-making regarding targeted intervertebral angle, screw-insertion dimension, and rod contouring.
本研究旨在探讨正常人群脊柱骨盆矢状形态及其腰椎各组成部分。共回顾性评估了 132 名成年志愿者,并根据 Roussouly 分类将其分为四组。对包括腰椎前凸角(LL)、胸腰椎后凸角(TK)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、PI-LL、LL-TK、L1 到 L5 椎体的腰椎前凸(L1L-L5L)、L1 到 L5 节段间角(IVA1-2-IVA5-1)、L1 到 L5 节段前凸(S1L-S5L)、L1 到 L5 节段比例(L1%-L5%)、L1 到 L5 节段间角比例(IVA1-2%-IVA5-1%)和 L1 到 L5 节段前凸比例(S1L%-S5L%)等影像学参数进行了统计学分析。根据分类,II 型(n=46)最为常见,其次为 I 型(n=39)、III 型(n=36)和 IV 型(n=11)。得出了四组矢状位参数的定量值。结果表明,LL、PI、SS 和 LL-TK 等参数存在显著差异。此外,L1%、L2%、L3%、IVA1-2%、IVA2-3%、S1L%、S2L%和 S3L%呈递增趋势。PI 与 LL、S1L、S2L、S3L、S4L、S1L%和 S2L%呈正相关,与 S5L 无相关性。综上所述,骨盆参数对腰椎曲度和前凸分布有显著影响。此外,上述结果有利于针对特定节段间角、螺钉置入维度和棒状轮廓进行个体化手术决策。