中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (36): 5753-5758.doi: 10.12307/2024.676

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

Lenke5型青少年特发性脊柱侧凸腰椎与骨盆参数的相关性

侯俞彤1，黄承兰1，杨云霄1，李  娅1，郭培武2，于文强3，赵  宇4，王赞博4，曾  红5，马振江6，鲁德志6，王金武6   

  1. 1潍坊医学院康复医学院，山东省潍坊市   261053；2潍坊市人民医院康复科，山东省潍坊市   261053；3浙江大学医学院附属第一医院康复科，浙江省杭州市   310003；4上海交通大学转化医学研究院，上海市   201100；上海交通大学医学院附属第九人民医院，5康复科，6骨科，上海市   200011
  • 收稿日期:2023-08-23 接受日期:2023-10-30 出版日期:2024-12-28 发布日期:2024-02-27
  • 通讯作者: 王金武，博士，教授，主任医师，上海交通大学医学院附属第九人民医院骨科，上海市 200011
  • 作者简介:侯俞彤，女，1997年生，山东省烟台市人，汉族，主要从事脊柱侧凸相关康复方面的研究。 黄承兰，女，1997年生，贵州省毕节市人，彝族，主要从事肌肉骨骼康复、康复工程方面的研究。
  • 基金资助:
    国家科技部重点研发计划项目(2020YFC2008700)，项目参与人：于文强；上海交通大学医学院附属第九人民医院临床研究型MDT项目(201914)，项目负责人：王金武；转化医学国家重大科技基础设施(上海)开放课题基金(TMSK-2021-140)，项目参与人：王金武；上海市科委项目(22015820100)，项目参与人：王金武；贵州省科技支撑计划(黔科合支撑【2023】一般196)，项目参与人：王金武

Correlation between lumbar spine and pelvic parameters in Lenke type 5 adolescent idiopathic scoliosis

Hou Yutong1, Huang Chenglan1, Yang Yunxiao1, Li Ya1, Guo Peiwu2, Yu Wenqiang3, Zhao Yu4, Wang Zanbo4, Zeng Hong5, Ma Zhenjiang6, Lu Dezhi6, Wang Jinwu6   

  1. 1School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China; 2Department of Rehabilitation, Weifang People’s Hospital, Weifang 261053, Shandong Province, China; 3Department of Rehabilitation, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China; 4Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai 201100, China; 5Department of Rehabilitation Medicine, 6Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Received:2023-08-23 Accepted:2023-10-30 Online:2024-12-28 Published:2024-02-27
  • Contact: Wang Jinwu, MD, Professor, Chief physician, Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • About author:Hou Yutong, School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China Huang Chenglan, School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
  • Supported by:
    National Key Research & Development Program of China, No. 2020YFC2008700 (to YWQ); Clinical Research Project of Multi-Disciplinary Team of Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 201914 (to WJW); National Facility for Translational Medicine (Shanghai) Open Project Fund, No. TMSK-2021-140 (to WJW); Project of Shanghai Science and Technology Commission, No. 22015820100 (to WJW); Guizhou Science and Technology Support Plan, No. [2023]196 (to WJW)

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摘要：


文题释义：

相关性分析：是指对2个或多个具备相关性的变量元素进行分析，从而衡量变量元素的相关密切程度，可分为正相关、负相关、不相关3种关系。
相关系数(r)：用来衡量2个变量之间的线性相关程度的指标，|r|的值越接近1，则变量之间的相关性程度就越高；越接近于0，则变量之间的相关性程度就越低。


背景：目前对于Lenke5型主腰弯脊柱侧凸患者腰椎与骨盆的研究仅局限于冠状面及矢状面，尚未明确侧弯与骨盆间的三维关系。

目的：分析Lenke5型主腰弯脊柱侧凸患者腰椎侧弯对骨盆的影响，研究腰椎与骨盆三维空间位置的相关性。
方法：回顾性分析上海交通大学医学院附属第九人民医院3D打印接诊中心2019年1月至2023年9月收治的60例Lenke5型主腰弯脊柱侧凸患者的影像学数据，包括Cobb角、冠状骨盆倾斜、腰椎前凸角、左右骨盆髋骨宽度比值、脊柱旋转角度、骨盆倾斜、骶骨斜率、骨盆入射角、冠状畸形角比率、矢状畸形角比率、C7铅垂线与骶骨中垂线的距离、椎体顶点平移、冠状骶骨倾角，将信息汇总为数据库，运用SPSS 22.0软件采用Spearman相关性分析和线性回归分析Lenke5型主腰弯青少年特发性脊柱侧凸患者腰椎与骨盆的相关数据。

结果与结论：①Cobb角与冠状畸形角比率、椎体顶点平移距离、脊柱旋转角度呈高度正相关关系(r=0.91，r=0.841，r=0.736)；②冠状畸形角比率与椎体顶点平移距离呈高度正相关关系(r=0.737)，与C7铅垂线到骶骨中垂线的距离呈中度正相关关系(r=0.514)，与矢状畸形角比率呈中度负相关关系(r=-0.595)；③腰椎前凸角与矢状畸形角比率呈高度正相关关系(r=0.942)，与冠状畸形角比率呈中度负相关关系(r= -0.554)；④Cobb角与冠状骨盆倾斜角、冠状骶骨倾角呈中度正相关关系(r=0.522，r=0.534)，C7铅垂线到骶骨中垂线的距离与冠状骨盆倾斜角呈中度正相关关系(r=0.507)；椎体顶点平移距离与冠状骨盆倾斜角、冠状骶骨倾角呈中度正相关关系(r=0.507，r=0.506)，腰椎前凸角与骶骨斜率、骨盆入射角呈中度正相关关系(r=0.512，r=0.538)；矢状畸形角比率与骶骨斜率、骨盆入射角呈中度正相关关系(r=0.614，r=0.621)；⑤结果发现腰椎与骨盆相对位置在水平面、矢状面、冠状面上息息相关，当腰椎出现侧凸、旋转时，骨盆的相对位置也会变化进行代偿，这表明矫正脊柱侧凸的同时，也不能忽略骨盆的矫正。

https://orcid.org/0009-0005-9938-3359 (侯俞彤) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 青少年特发性脊柱侧凸, Lenke5型, 腰椎, 骨盆, 三维评估, 相关性

Abstract: BACKGROUND: The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes, and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified.
OBJECTIVE: To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis.
METHODS: Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed, including Cobb angle, coronal pelvic tilt, lumbar lordosis, left and right pelvic hip width ratio (sacroiliac-anterior superior iliac spine), spinal rotation angle, pelvic tilt, sacral slope, pelvic incidence, coronal deformity angular ratio, sagittal deformity angular ratio, C7 plumb line-center sacral vertical line, apical vertebral translation, and coronal sacral inclination. The information was summarized as a database. SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman’s correlation analysis and linear regression.
RESULTS AND CONCLUSION: (1) Cobb angle was highly positively correlated with coronal deformity angular ratio, apical vertebral translation, and spinal rotation angle (r=0.91, r=0.841, r=0.736). (2) Coronal deformity angular ratio was highly positively correlated with apical vertebral translation (r=0.737), moderately positively correlated with C7 plumb line-center sacral vertical line (r=0.514), and moderately negatively correlated with sagittal deformity angular ratio (r=-0.595). (3) There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio (r=0.942) and a moderate negative correlation with coronal deformity angular ratio (r=-0.554). (4) There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination (r=0.522, r=0.534) and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt (r=0.507). Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation (r=0.507, r=0.506). Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation (r=0.512, r=0.538). Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence (r=0.614, r=0.621). (5) Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal, sagittal and coronal planes. When the lumbar spine affects scoliosis and is rotated, the relative position of the pelvis will also change to compensate, which indicates that while correcting scoliosis, the correction of the pelvis cannot be ignored.

Key words: adolescent idiopathic scoliosis, Lenke type 5, lumbar spine, pelvis, three-dimensional evaluation, correlation

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