Affiliated Hospital of Jining Medical University, Jining Medical University, Guhuai Road 89, Jining, 272007, China.
Department of Orthopedics, Shandong University of Traditional Chinese Medicine, Jingshi Road 16369, Jinan, 250014, China.
Eur J Med Res. 2023 Oct 5;28(1):403. doi: 10.1186/s40001-023-01339-5.
To evaluate the effects of correction in lumbar lordosis (LL) that have on full-body realignments in patients with degenerative lumbar scoliosis (DLS) who had undergone long sacroiliac fusion surgery.
A multi-center retrospective study including 88 DLS patients underwent the surgical procedure of long sacroiliac fusion with instrumentations was performed. Comparisons of radiographic and quality-of-life (QoL) data among that at the pre-operation, the 3rd month and the final follow-up were performed. The correlations between the LL correction and the changes in other spinopelvic parameters were explored using Pearson-correlation linear analysis and linear regression analysis. The correlation coefficient (r) and the adjusted r were calculated subsequently.
All radiographic and QoL data improved significantly (P < 0.001) after the surgical treatments. The LL correction correlated (P < 0.001) with the changes in the sacral slope (SS, r = 0.698), pelvic tilt (PT, r = -0.635), sagittal vertical axis (SVA, r = -0.591), T1 pelvic angle (TPA, r = -0.782), and the mismatch of pelvic incidence minus lumbar lordosis (PI-LL, r = -0.936), respectively. Moreover, LL increased by 1° for each of the following spinopelvic parameter changes (P < 0.001): 2.62° for SS (r = 0.488), -4.01° for PT (r = 0.404), -4.86° for TPA (r = 0.612), -2.08° for the PI-LL (r = 0.876) and -15.74 mm for SVA (r = 0.349). Changes in the thoracic kyphosis (r = 0.259) and pelvic femur angle (r = 0.12) were independent of the LL correction, respectively.
LL correction correlated significantly to the changes in spinopelvic parameters; however, those independent variables including the thoracic spine and hip variables probably be remodeled themselves to maintain the full-body balance in DLS patients underwent the correction surgery.
评估腰椎前凸（LL）矫正对退行性腰椎侧凸（DLS）患者行长节段骶髂融合术后全身矫形的影响。
进行了一项多中心回顾性研究，纳入 88 例接受长节段骶髂融合内固定术的 DLS 患者。比较术前、术后 3 个月和最终随访时的影像学和生活质量（QoL）数据。采用 Pearson 相关线性分析和线性回归分析探讨 LL 矫正与其他脊柱骨盆参数变化的相关性。计算相关系数（r）和调整 r。
所有影像学和 QoL 数据在手术治疗后均显著改善（P<0.001）。LL 矫正与骶骨倾斜度（SS）（r=0.698）、骨盆倾斜度（PT）（r=-0.635）、矢状垂直轴（SVA）（r=-0.591）、T1 骨盆角（TPA）（r=-0.782）和骨盆入射角与腰椎前凸差值（PI-LL）（r=-0.936）的变化显著相关（P<0.001）。此外，每矫正 1°LL，以下脊柱骨盆参数变化分别增加（P<0.001）：SS 增加 2.62°（r=0.488），PT 减少 4.01°（r=0.404），TPA 减少 4.86°（r=0.612），PI-LL 减少 2.08°（r=0.876），SVA 减少 15.74mm（r=0.349）。胸腰椎后凸（r=0.259）和骨盆股骨角（r=0.12）的变化与 LL 矫正无关。
LL 矫正与脊柱骨盆参数变化显著相关；然而，包括胸段脊柱和髋关节在内的这些独立变量可能会自行重塑，以维持行矫正手术的 DLS 患者的全身平衡。
