CAJ | 학술논문

骨关节植入物%脊柱植入物%腰椎滑脱症%内固定%脊柱骨盆参数%滑移度%滑脱角%椎间盘高度%后路椎体间融合%腰椎前凸%骨盆倾斜角%骶骨倾斜角骨關節植入物%脊柱植入物%腰椎滑脫癥%內固定%脊柱骨盆參數%滑移度%滑脫角%椎間盤高度%後路椎體間融閤%腰椎前凸%骨盆傾斜角%骶骨傾斜角
골관절식입물%척주식입물%요추활탈증%내고정%척주골분삼수%활이도%활탈각%추간반고도%후로추체간융합%요추전철%골분경사각%저골경사각
bone and joint implants%spinal implants%lumbar spondylolisthesis%internal fixation%spino-pelvic parameters%slip degree%slip angle%height of intervertebral disc%posterior lumbar interbody fusion%lumbar lordosis%pelvic tilting angle%sacral slope angle

背景:脊柱-骨盆参数的异常与腰椎椎体滑脱症的发生、进展密切相关.目的:探讨腰椎椎体滑脱症患者内固定治疗后脊柱-骨盆参数的变化及临床意义.方法:行腰椎椎体滑脱症后路腰椎椎体间融合内固定治疗且有完整随访资料的患者共60例,测量分析所有患者内固定前后 X 射线平片的腰椎前凸、骨盆投射角、骶骨倾斜角和骨盆倾斜角、矢状面平衡、椎体滑脱度、椎体滑脱角和椎间盘高度.将上述参数植入前后测量结果进行配对 t 检验比较,并对相关参数指标进行相关分析.结果与结论:植入前后滑脱度、滑脱角、椎间盘高度、腰椎前凸、骨盆倾斜角、骶骨倾斜角及矢状面平衡比较,差异均有显著性意义(P <0.01).椎间盘高度的恢复与腰椎前凸、骨盆倾斜角、骶骨倾斜角、滑脱度及滑脱角的变化存在明显的线性相关,腰椎前凸的变化与滑脱角、滑脱度、骨盆倾斜角及骶骨倾斜角的变化存在线性相关.说明后路腰椎椎间融合内固定能够显著地改善腰椎椎体滑脱症患者的骶骨倾斜角、骨盆倾斜角、腰椎前凸及矢状面平衡;运用后路腰椎椎间融合内固定治疗腰椎椎体滑脱症患者,必须考虑不同骨盆投射角下的骨盆代偿模式,个体化地重建椎间盘高度.
배경:척주-골분삼수적이상여요추추체활탈증적발생、진전밀절상관.목적:탐토요추추체활탈증환자내고정치료후척주-골분삼수적변화급림상의의.방법:행요추추체활탈증후로요추추체간융합내고정치료차유완정수방자료적환자공60례,측량분석소유환자내고정전후 X 사선평편적요추전철、골분투사각、저골경사각화골분경사각、시상면평형、추체활탈도、추체활탈각화추간반고도.장상술삼수식입전후측량결과진행배대 t 검험비교,병대상관삼수지표진행상관분석.결과여결론:식입전후활탈도、활탈각、추간반고도、요추전철、골분경사각、저골경사각급시상면평형비교,차이균유현저성의의(P <0.01).추간반고도적회복여요추전철、골분경사각、저골경사각、활탈도급활탈각적변화존재명현적선성상관,요추전철적변화여활탈각、활탈도、골분경사각급저골경사각적변화존재선성상관.설명후로요추추간융합내고정능구현저지개선요추추체활탈증환자적저골경사각、골분경사각、요추전철급시상면평형;운용후로요추추간융합내고정치료요추추체활탈증환자,필수고필불동골분투사각하적골분대상모식,개체화지중건추간반고도.
@@@@BACKGROUND: Abnormality of spnio-pelvic parameters is closely related to the occurrence and progress of lumbar spondylolisthesis. OBJECTIVE: To explore the change and clinical significance of spino-pelvic parameters in lumbar spondylolisthesis patients after internal fixation. METHODS: A retrospective analysis was conducted on 60 patients with lumbar spondylolisthesis undergoing posterior lumbar interbody fusion and internal fixation. The pre-and post-operative lumbar lordosis, pelvic projectional angle, sacralslope angle, pelvic tilting angle, sagittal balance, slip degree, slip angle and height of intervertebral disc were measured on X-ray film. These parameters were analyzed using t-test between pre- and post-operation. Linear correlations between these parameters were analyzed. RESULTS AND CONCLUSION: There were significant differences between pre- and post-operative slip degree, slip angle, height of intervertebral disc, lumbar lordosis, pelvic tilting, sacral slope and sagittal balance (P < 0.01). The restoration of height of intervertebral disc showed significant correlation with the change of lumbar lordosis, pelvic tilting, sacral slope, slip degree and slip angle. The change of lumbar lordosis was significantly correlated with the change of slip angle, slip degree, pelvic tilting and sacral slope. It indicates that posterior lumbar interbody fusion and internal fixation can significantly improve the sacral slope, pelvic tilting, lumbar lordosis and sagittal balance of the patients with lumbar spondylolisthesis. Therefore, when treating lumbar spondylolisthesis patients with posterior lumbar interbody fusion and internal fixation, compensatory mode of pelvis with different pelvic projectional angles must be considered, and surgical surgeons should restore the height of intervertebral disc individual y.