中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (4): 564-570.doi: 10.3969/j.issn.2095-4344.2016.04.020

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

腰椎退变性后凸截骨矫形内固定后矢状面的平衡变化

任周梁1,朱松青2,梁卫东1,盛伟斌1,盛 军1   

  1. 1新疆医科大学第一附属医院脊柱外科,新疆维吾尔自治区乌鲁木齐市 830054;2新疆医科大学第六附属医院脊柱外科,新疆维吾尔自治区乌鲁木齐市 830002
  • 收稿日期:2015-12-19 出版日期:2016-01-22 发布日期:2016-01-22
  • 通讯作者: 盛伟斌,博士,主任医师,教授,博士生导师,新疆医科大学第一附属医院脊柱外科,新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:任周梁,男,1991年生,四川省仪陇县人,汉族,新疆医科大学在读硕士,主要从事脊柱疾患的基础与临床研究。
  • 基金资助:
    新疆维吾尔自治区自然科学基金资助项目(2014211C026)

Changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis

Ren Zhou-liang1, Zhu Song-qing2, Liang Wei-dong1, Sheng Wei-bin1, Sheng Jun1   

  1. 1Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China; 2Department of Spine Surgery, Six Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, Xinjiang Uygur Autonomous Region, China
  • Received:2015-12-19 Online:2016-01-22 Published:2016-01-22
  • Contact: Sheng Wei-bin, M.D., Chief physician, Professor, Doctoral supervisor, Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Ren Zhou-liang, Studying for master’s degree, Department of Spine Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2014211C026

摘要:

文章快速阅读:

文题释义:

腰椎退变性后凸:是腰椎多个椎间隙变窄、椎体楔形塌陷、腰大肌萎缩等退行性改变引起的脊柱在矢状面上出现腰椎生理性前凸减小、丢失甚至变成腰椎后凸的一种畸形。多见于亚洲的中老年女性,发病机制主要与患者的生活方式及长期低头弯腰负重劳动姿势有关。

矢状面平衡:为过C7椎体中心的铅垂线距S1后上角之间的水平距离。正常的C7铅垂线通过S1后上角,若铅垂线位于骶骨后上角前方记为正值,后方为负值。C7铅垂线作为经典且简易的评价矢状面平衡指标,常被用于评价脊柱骨盆作为一个整体与矢状面平衡的关系。畸形手术治疗的主要目的在于恢复脊柱-骨盆矢状面的平衡,重建脊柱的稳定性。 

ORCID: 0000-0002-3342-2504(任周梁)

关键词: 骨科植入物, 脊柱植入物, 腰椎后凸, 截骨, 矢状面平衡, 脊柱后凸, 矫形, 矢状面平衡, 腰椎后凸角, 胸椎后凸角, 骨盆倾斜角, 新疆维吾尔自治区自然科学基金

Abstract:

BACKGROUND: At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters following corrective osteotomy for lumbar degenerative kyphosis have not been reported.
OBJECTIVE: To evaluate postoperative changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis.
METHODS: We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final follow-up.
RESULTS AND CONCLUSION: (1) There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle (P < 0.05). (2) There were significant differences between postoperative and last follow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis (P < 0.05). (3) Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation (r=-0.610, P < 0.001). Thoracic kyphosis was positively correlated with lumbar lordosis (r=0.598, P < 0.001). (4) Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.