Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Eur Spine J. 2024 Dec;33(12):4598-4604. doi: 10.1007/s00586-024-08441-0. Epub 2024 Aug 7.
The aim of this study was to explore the correlation between PI and standing-to-sitting changes of the sagittal alignment in patients with lumbar degenerative diseases, and investigate the differences in posture changes among Roussouly types.
A total of 209 patients with lumbar degenerative disease were retrospectively included in this study. All the patients received lateral full body imaging in both standing and sitting positions. Sagittal parameters including SVA, OD-HA, PT, PI, PT/PI, SS, LL, TK, Upper LL (L1-L4) and Lower LL (L4-S1) were measured in both standing and sitting position, and the parameters were compared between two positions. The correlations between PI and lumbo-pelvic changes were analyzed. The postural changes were compared among different Roussouly types.
From standing to sitting, all the parameters except PI significantly changed, including SVA, OD-HA, PT, PT/PI, SS, LL, TK, Upper LL and Lower LL. The contribution of lower LL was greater to global LL than upper LL. PI had a significant correlation with ΔPT, ΔSS, ΔLL, ΔUpper LL and ΔLower LL. From standing to sitting, type 4 patients had the most pronounced ΔPT, ΔSS and ΔLL, and ΔLower LL of types 3 and 4 were greater than that of types 1 and 2.
In patients with degenerative disease, PI plays an important role in determining the extent of lumbo-pelvic changes from standing to sitting. Among different Roussouly types, type 4 patients have the most pronounced changes of PT, SS and LL, suggesting the relatively greater flexibility of pelvis and lumbar spine.
本研究旨在探讨腰椎退行性疾病患者骨盆入射角（PI）与站立位到坐位矢状面参数变化的相关性，并研究不同 Roussouly 分型间的体位变化差异。
回顾性纳入 209 例腰椎退行性疾病患者，所有患者均接受站立位和坐位全脊柱侧位片检查。测量站立位和坐位时的矢状位参数，包括 SVA、OD-HA、PT、PI、PT/PI、SS、LL、TK、上腰椎（L1-L4）和下腰椎（L4-S1），并比较两种体位下的参数差异。分析 PI 与腰骨盆变化的相关性，比较不同 Roussouly 分型间的体位变化。
与站立位相比，除 PI 外，所有参数均有显著变化，包括 SVA、OD-HA、PT、PT/PI、SS、LL、TK、上腰椎和下腰椎。下位腰椎对总 LL 的贡献大于上位腰椎。PI 与 ΔPT、ΔSS、ΔLL、ΔUpper LL 和 ΔLower LL 均有显著相关性。从站立位到坐位，4 型患者的 ΔPT、ΔSS 和 ΔLL 最大，3 型和 4 型的 ΔLower LL 大于 1 型和 2 型。
在退行性疾病患者中，PI 在确定站立位到坐位时腰骨盆变化程度方面起着重要作用。在不同 Roussouly 分型中，4 型患者的 PT、SS 和 LL 变化最明显，提示骨盆和腰椎的灵活性相对较大。
