Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan.
J Med Invest. 2023;70(1.2):135-139. doi: 10.2152/jmi.70.135.
To evaluate segmental mobility with degenerative lumbar spondylolisthesis (DLS), upright lateral flexion-extension radiographs (FE) are widely used. However, some authors have described that a combination of lateral radiographs in the standing position and supine sagittal image (SS) reveal more segmental mobility than FE. The purpose of this study was to investigate the optimal method for evaluating segmental mobility with DLS.
We included 92 consecutive Japanese patients diagnosed with DLS. Sagittal translation (ST) determined by FE and SS were compared. Pathological instability was defined as ST more than 8% of the upper vertebra. Patients were divided into those diagnosed with pathological instability in FE (PI-FE) and those diagnosed with SS (PI-SS), and lumbar lordosis (LL) in the standing position in each group were compared.
ST in FE was significantly greater than in SS. Of 92 patients, 31 had pathological instability in FE or SS ; 17 patients had PI-FE, and 10 patients had PI-SS. LL in the standing position in PI-FE was significantly smaller than in PI-SS.
ST in FE was greater than that in SS, contrary to previous studies' reports on Caucasians. Since Japanese individuals have smaller LL than Caucasians, FE tends to reveal more segmental mobility than SS. J. Med. Invest. 70 : 135-139, February, 2023.
评估退行性腰椎滑脱症（DLS）的节段运动度，广泛使用直立侧屈伸展位（FE）侧位片。然而，一些作者描述，站立位侧位片与仰卧位矢状位图像（SS）的组合比 FE 能揭示更多的节段运动度。本研究的目的是研究评估 DLS 节段运动度的最佳方法。
我们纳入了 92 例连续的日本退行性腰椎滑脱症患者。比较 FE 和 SS 确定的矢状面平移（ST）。FE 诊断为病理性不稳定（PI-FE）和 SS（PI-SS）的患者，以及每组站立位腰椎前凸（LL）的比较。
FE 中的 ST 明显大于 SS。92 例患者中，31 例 FE 或 SS 存在病理性不稳定；17 例 PI-FE，10 例 PI-SS。PI-FE 中站立位的 LL 明显小于 PI-SS。
FE 中的 ST 大于 SS，与以前对高加索人的研究报告相反。由于日本人的 LL 比高加索人小，FE 往往比 SS 显示更多的节段运动度。医学研究杂志 70：135-139，2023 年 2 月。
