CAJ | 학술논문

目的：研究腰椎峡部裂滑脱症患者手术治疗前后脊柱骨盆矢状位影像学参数变化。方法回顾分析54例施行单节段腰椎椎间 cage 融合术治疗的腰椎峡部裂滑脱患者资料,术前及随访时拍摄站立位脊柱全长正、侧位 X 线片,测量手术前后胸椎后凸(TK)、胸腰联合角(TLJ)、C7矢状面平衡(SVA)、脊柱-骨盆角(SSA)、腰椎前凸角(LL)、骶骨倾斜角(SS)、骨盆倾斜角(PT)和骨盆入射角(PI),并应用 Pearson 相关系数对影像学结果进行相关分析。结果脊柱-骨盆相关参数中,除 PI、TLJ 和 TK 外,其余参数手术前后比较差异均有统计学意义(P <0．05,P <0．01)。 SSA 的变化与 PT、PI、LL、SS 及 SVA 的变化存在线性关系。结论腰椎后路椎间融合术可明显改善腰椎峡部裂滑脱症患者的脊柱骨盆矢状位状态,术前及术后的 SSA 可对患者脊柱矢状面平衡进行评估,SSA 的重建可作为手术疗效评价的重要参考依据。
목적：연구요추협부렬활탈증환자수술치료전후척주골분시상위영상학삼수변화。방법회고분석54례시행단절단요추추간 cage 융합술치료적요추협부렬활탈환자자료,술전급수방시박섭참립위척주전장정、측위 X 선편,측량수술전후흉추후철(TK)、흉요연합각(TLJ)、C7시상면평형(SVA)、척주-골분각(SSA)、요추전철각(LL)、저골경사각(SS)、골분경사각(PT)화골분입사각(PI),병응용 Pearson 상관계수대영상학결과진행상관분석。결과척주-골분상관삼수중,제 PI、TLJ 화 TK 외,기여삼수수술전후비교차이균유통계학의의(P <0．05,P <0．01)。 SSA 적변화여 PT、PI、LL、SS 급 SVA 적변화존재선성관계。결론요추후로추간융합술가명현개선요추협부렬활탈증환자적척주골분시상위상태,술전급술후적 SSA 가대환자척주시상면평형진행평고,SSA 적중건가작위수술료효평개적중요삼고의거。
Objective To explore the change of the sagittal alignment of the spine and pelvis before and after surgery for isthmic lumbar spondylolisthesis. Methods Spondylolisthesis patients,who underwent surgical posterior interver-tebral fusion combined with pedicle screw fixation,were retrospectively reviewed. The pre-and post-operative radio-graphic parameters,such as thoracic kyphosis(TK),thoracolumbar junction angle(TLJ)sagittal vertical axis(SVA), spino-sacral angle(SSA),lumbar lordosis(LL),sacral slope (SS),pelvic incidence(PI) and pelvic tilt (PT) were measured. Changes of preoperative and postoperative radiographic parameters were evaluated. Pearson′s correlation coeffieients were used to investigate the association of all parameters. Results PI,TLJ and TK were unaffected by surgery. The alteration of SSA showed significant correlation with the change of PT,PI,LL,SS and SVA. Conclusions Surgical posterior intervertebral fusion combined with pedicle screw fixation of spondylolisthesis can effectively im-prove and maintain the spinal sagittal parameters. SSA is closely related with good clinical outcome,which can be a reference for evaluating spinopelvic sagittal alignment balance and operation strategy.