Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China.
Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, China.
Clin Neurol Neurosurg. 2023 Oct;233:107940. doi: 10.1016/j.clineuro.2023.107940. Epub 2023 Aug 11.
To compare the differences of spinopelvic morphology among patients with DISH, patients without DISH and normal elderly and to assess the impact of ossification extent on sagittal alignment.
Patients with and without DISH aged > 50 years who required surgery because of lumbar spinal stenosis were enrolled in this cohort(DISH and Non-DISH groups). Also, we collected age-matched normal old outpatients as the control group(Normal group). According to ossification extent, DISH group were divided into two subgroups(T-DISH and L-DISH subgroups). Spinopelvic parameters were measured. Distribution differences of Roussouly classification were analyzed between DISH and Non-DISH group, T-DISH and L-DISH subgroup, respectively. Additionally, distribution difference of kyphotic apex vertebrae between T-DISH and L-DISH subgroup was also investigated.
A total of 429 patients (300 males and 129 females) were enrolled in our study, with a mean age of 64.1 ± 5.8 years. Compared to the Normal group, DISH and Non-DISH groups both had significantly higher CSVA, PT, OH, SVA, TPA and lower LL, SS, C7 Tilt, SSA, SPA. Compared to Non-DISH group, DISH group, regardless of ossification extent, had significantly higher T1 slope, CSVA, TK and SVA. Besides, T-DISH subgroup showed significant higher LL, PI, SS and SSA than L-DISH subgroup. There were significant differences of Roussouly classification distribution between T-DISH and L-DISH subgroup. In terms of kyphotic apex location, compared to relatively higher locations in T-DISH subgroup, L-DISH subgroup had apical locations predominantly in the lower thoracic.
Sagittal spinopelvic alignment is influenced by the presence of DISH and the extent of ossification. Patients with L-DISH have not only increased thoracic kyphosis and forward trunk, but also insufficient lumbar lordosis.
比较 DISH 患者、无 DISH 患者和正常老年人之间脊柱骨盆形态的差异，并评估骨化程度对矢状面排列的影响。
本队列纳入因腰椎管狭窄症需手术治疗的年龄>50 岁的 DISH 患者和无 DISH 患者（DISH 和非 DISH 组），并收集年龄匹配的正常老年门诊患者作为对照组（正常组）。根据骨化程度，DISH 组分为 T-DISH 和 L-DISH 亚组。测量脊柱骨盆参数。分析 DISH 组和非 DISH 组、T-DISH 亚组和 L-DISH 亚组之间 Roussouly 分类的分布差异。此外，还研究了 T-DISH 亚组和 L-DISH 亚组之间后凸顶点椎体的分布差异。
本研究共纳入 429 例患者（300 名男性和 129 名女性），平均年龄为 64.1±5.8 岁。与正常组相比，DISH 组和非 DISH 组的 CSVA、PT、OH、SVA、TPA 均较高，LL、SS、C7 倾斜角、SSA、SPA 均较低。与非 DISH 组相比，无论骨化程度如何，DISH 组的 T1 斜率、CSVA、TK 和 SVA 均显著较高。此外，T-DISH 亚组的 LL、PI、SS 和 SSA 均显著高于 L-DISH 亚组。T-DISH 亚组和 L-DISH 亚组之间的 Roussouly 分类分布存在显著差异。在后凸顶点位置方面，与 T-DISH 亚组中相对较高的位置相比，L-DISH 亚组的顶点位置主要位于胸下段。
矢状面脊柱骨盆排列受 DISH 的存在和骨化程度的影响。L-DISH 患者不仅胸椎后凸增加、躯干前倾，而且腰椎前凸不足。
