Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.
National Clinical Research Center for Geriatric Diseases, Beijing, China.
BMC Musculoskelet Disord. 2023 Mar 27;24(1):229. doi: 10.1186/s12891-023-06310-3.
To generate a compensatory classification to evaluate sagittal spinal malalignment with lumbar degeneration.
We included 162 patients with low back pain who underwent full-length spinal radiography in our hospital from August 2019 to October 2021. Using full-length spine X-rays, we measured pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), C7 slope (C7S), thoracolumbar kyphosis (TLK), and C7 sagittal vertical axis (SVA). We also recorded the Oswestry Disability Index (ODI) and visual analog scale (VAS). Patients were divided into four groups based on the SRS-Schwab classification and four other groups based on the compensatory classification.
ODI correlated with age, SS, LL, TK, C7-SVA, SRS-Schwab classification, and compensatory classification. Lumbar VAS score correlated with LL, TK, C7-SVA, SRS-Schwab classification, and compensatory classification. Leg VAS score only correlated with LL. Hidden imbalance and imbalance with compensation had more significant PT and larger TK than balance patients. The symptoms of the four compensatory classification groups gradually worsened.
The spinal-pelvic sagittal balance in patients with lumbar degeneration based on pelvic and thoracic compensation can reflect spinal balance and symptoms. This parameter might help evaluate spine sagittal alignment in elderly patients with lumbar degeneration.
生成一种代偿性分类，以评估伴有腰椎退变的矢状位脊柱失平衡。
我们纳入了 2019 年 8 月至 2021 年 10 月在我院因腰痛接受全长脊柱 X 线摄影的 162 例患者。我们使用全长脊柱 X 线片测量骨盆倾斜角（PT）、骶骨倾斜角（SS）、骨盆入射角（PI）、胸腰椎后凸角（TK）、腰椎前凸角（LL）、C7 倾斜角（C7S）、胸腰椎后凸角（TLK）和 C7 矢状位垂直轴（C7SVA）。还记录了 Oswestry 功能障碍指数（ODI）和视觉模拟评分（VAS）。患者根据 SRS-Schwab 分类分为四组，根据代偿性分类分为四组。
ODI 与年龄、SS、LL、TK、C7-SVA、SRS-Schwab 分类和代偿性分类相关。腰椎 VAS 评分与 LL、TK、C7-SVA、SRS-Schwab 分类和代偿性分类相关。下肢 VAS 评分仅与 LL 相关。隐性失平衡和有代偿的失平衡患者的 PT 更大，TK 更大，与平衡患者相比。四个代偿性分类组的症状逐渐恶化。
基于骨盆和胸椎代偿的腰椎退变患者的脊柱骨盆矢状位平衡可以反映脊柱平衡和症状。该参数可能有助于评估老年腰椎退变患者的脊柱矢状位排列。
