CAJ | 학술논문

目的：探讨骨盆矢状位参数对退行性腰椎滑脱症的影响。方法：回顾性分析72例退行性腰椎滑脱症患者的影像学资料，男25例，女47例。年龄45～78岁，中位数68岁。单节段滑脱65例，两节段滑脱7例。MeyerdingⅠ度滑脱48例、Ⅱ度滑脱24例。50例健康成人，男22例，女28例。年龄45～70岁，中位数55岁。对72例患者及50例健康成人脊柱全长侧位 X 线片上的骨盆入射角、骨盆倾斜角、骶骨倾斜角进行测量和比较分析，并对Ⅰ度与Ⅱ度腰椎滑脱患者的骨盆入射角进行比较。结果：退行性腰椎滑脱患者骨盆入射角、骶骨倾斜角均大于健康成人组（54．90°±5．10°，50．46°±4．31°，t ＝2．770，P ＝0．007；44．96°±4．87°，40．14°±4．06°，t ＝3．360，P ＝0．001）；退行性腰椎滑脱组骨盆倾斜角与健康成人组比较，差异无统计学意义（9．94°±2．14°，10．54°±1．71°，t ＝－1．638，P ＝0．104）。Ⅱ度滑脱患者的骨盆入射角大于Ⅰ度滑脱患者的骨盆入射角（58．14°±3．09°，53．06°±3．01°，t ＝－9．143，P ＝0．000）。结论：骨盆入射角、骶骨倾斜角增大，腰椎发生退行性滑脱的风险会增加，同时骨盆入射角增大也会使腰椎滑脱的程度加重。
목적：탐토골분시상위삼수대퇴행성요추활탈증적영향。방법：회고성분석72례퇴행성요추활탈증환자적영상학자료，남25례，녀47례。년령45～78세，중위수68세。단절단활탈65례，량절단활탈7례。MeyerdingⅠ도활탈48례、Ⅱ도활탈24례。50례건강성인，남22례，녀28례。년령45～70세，중위수55세。대72례환자급50례건강성인척주전장측위 X 선편상적골분입사각、골분경사각、저골경사각진행측량화비교분석，병대Ⅰ도여Ⅱ도요추활탈환자적골분입사각진행비교。결과：퇴행성요추활탈환자골분입사각、저골경사각균대우건강성인조（54．90°±5．10°，50．46°±4．31°，t ＝2．770，P ＝0．007；44．96°±4．87°，40．14°±4．06°，t ＝3．360，P ＝0．001）；퇴행성요추활탈조골분경사각여건강성인조비교，차이무통계학의의（9．94°±2．14°，10．54°±1．71°，t ＝－1．638，P ＝0．104）。Ⅱ도활탈환자적골분입사각대우Ⅰ도활탈환자적골분입사각（58．14°±3．09°，53．06°±3．01°，t ＝－9．143，P ＝0．000）。결론：골분입사각、저골경사각증대，요추발생퇴행성활탈적풍험회증가，동시골분입사각증대야회사요추활탈적정도가중。
Objective:To explore the effect of pelvic parameters in the sagittal plane on degenerative lumbar spondylolisthesis. Methods:The imaging data of 72 patients with degenerative lumbar spondylolisthesis were analyzed retrospectively.The patients consisted of 25 males and 47 females,and ranged in age from 45 to 78 years(Mean =68 yrs).The lumbar spondylolisthesis located in single segment for 65 patients and two segments for 7 patients and belonged to Meyerding grade Ⅰ(48)and Ⅱ(24).Fifty healthy adults(healthy adults group),consisted of 22 males and 28 females and ranged in age from 45 to 70 years(Mean =55 yrs),were also included.Pelvic incidence (PI),pelvic tilt(PT)and sacral slope(SS)on lateral X-ray film of total spine were measured and compared between 72 patients and 50 healthy adults.Meanwhile,the pelvic incidence(PI)was compared between gradeⅠand gradeⅡlumbar spondylolisthesis.Results:PI and SS were larger in patients with degenerative lumbar spondylolisthesis compared to healthy adults(54.90 +/-5.10 vs 50.46 +/-4.31 degrees, t =2.770,P =0.007;44.96 +/-4.87 vs 40.14 +/-4.06 degrees,t =3.360,P =0.001).There were no statistical differences in PI be-tween the two groups(9.94 +/-2.14 vs 10.54 +/-1.71 degrees,t =-1.638,P =0.104).PI were larger in patients with gradeⅡdegener-ative lumbar spondylolisthesis compared to those with gradeⅠdegenerative lumbar spondylolisthesis(58.14 +/-3.09 vs 53.06 +/-3.01 degrees,t =-9.143,P =0.000).Conclusion:The increament of PI and SS may increase the risk of degenerative lumbar spondylolisthe-sis,meanwhile,the increament of PI may also aggravate the degree of lumbar spondylolisthesis.