摘要
目的描述正常成人的骨盆矢状位形态，分析正常成人脊朴-骨盆矢状位序列类型。方法采用前赡性影像学分析对139名志愿者进行研究，男94名，女45名；年龄21-28岁，平均（23．5±1．5）岁。所有志愿者行全脊柱正、侧位X线检查，利用院内影像归档与通信系统（picture archiving and cornmunieation systems，PACS）测量骨盆入射角（pelvic incidence，PI）、骨盆倾斜角（pelvic tilt，PT）、骶骨倾斜角（sacral slope，SS）。按照脊柱矢状面解剖定义和形态特点描述脊柱各矢状面形态参数，分析各参数间相关性，并根据腰椎前凸顶点位置不同分析国人腰椎-骨盆矢状位序列类型。结果PI平均值为45．1°±9．6°，明显小于西方成人，并明显小于韩国成人；女性PI值明娃高于男性。骨盆各参数间密切相关，脊柱相邻前凸节段、后凸节段间密切相关，腰弯前凸还与颈弯前凸、矢状值平衡（sagittal vertical axis，SVA）密切相关；依据腰弯前凸顶点位置，将腰椎-骨盆矢状位序列分为四型：I型，顶点位于L5椎体或L4，5椎间隙，共11名（占7-8％）；Ⅱ型，顶点位于L4底部或中部，共61名（占43．3％）；Ⅲ型，顶点位于L4上部或L3，4椎间隙，共33名（占23.4％）；Ⅳ型，顶点位于L3椎体及其以上，共34名（占24．5％）。所有志愿者的胸弯后凸顶点为T6，7颈弯胸弯拐点为C7。各类型间骨盆矢状位形态、腰弯倾斜程度仔往明硅差异。结论中国正常成人骨盆矢状位形态与西方和韩国人群存在明显差异。腰椎通过骨盐的调节后，在维持脊柱整体矢状位平衡方面起到核心作用；随着腰弯前凸顶点提高，脊柱-骨盆序列将出现骶骨增加倾斜、下腰巧前凸角度增加、下腰弯组成椎体数量增加、腰弯倾斜减小等变化。
Objective To describe sagittal pelvic pattern, and to analyze sagittal spino-pelvic alignment in asymptomatie Chinese adults. Methods This was a prospective radiologieal analysis. Anteroposterior and lateral radiographs of the whole spine were taken in 139 Chinese vnlunteers, including 94 males and 45 females, aged from 21 to 28 years （average, 23.5±1.5 years）. By using picture arehiving and communicalion systems, several pelvic and spinal parameters （pelvic incidence, pelvic tilt, sacral slope, lumbar lnrdosis, thoraeie kyphosis, eervieal lordosis, sagittal vertical axis, apex of total lumbar lordosis, total lumbar lordosis, upper are of total lumbar lordosis, lower arc of total lumbar lordosis, junctional level, apex of total thoraeie kyphosis, total thoraeie kyphosis, total cervieal lordosis, and lordosis tilt） were measured and the correlations of all parameters were analyzed. Results The mean value of pelvic incidence was 45.1°±9.6°, which was significantly less than those reported in western and Korean subjeets. Total lmnbar lordosis has a significant correlation with pelvic ineidence, sacral slope, total thoraeie kyphosis, cervical lordosis and sagittal vertical axis. The sagittal lumbar-pelvic alignment was classified into 4 types according to position of apex of total lumbar lordosis： type I （11 eases）, the apex was Ioeated in 1,5 or intervertebral space between L4 and Ls; type 11 （61 cases）, the apex was located in bottom or middle of L4; type I11 （33 eases）, the apex was located in upper part of L4 or in intervertebral space between L3 and L4; type IV （34 eases）, the apex was located at L3 level or more high level. Conclusions The sagittal pelvic pattern of Chinese aduhs is significantly difterent from those of western and Korean. Lumbar lordosis plays a critical role in regulating spinal sagittal balance. With upper shift nf apex of total lumbar lordosis, the lower lumbar lordosis angle and sacral slope increase, but the lordosis tilt decreases.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2013年第5期447-453,共7页
Chinese Journal of Orthopaedics
基金
教育部留学回国人员科研启动基金
