切换至 "中华医学电子期刊资源库"
高级检索
中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (08) : 583 -588. doi: 10.3877/cma.j.issn.1674-0785.2019.08.005

所属专题： 文献；

临床研究

汉族老年人群脊柱-骨盆X线片矢状位参数特点及序列拟合关系分析
唐冲1, 刘正1,†(), 吴四军1   
  1. 1. 100144　北京大学首钢医院骨科
  • 收稿日期:2019-01-17 出版日期:2019-04-15
  • 通信作者: 刘正

Spinopelvic sagittal parameters and their regression analysis in an elderly Han population

Chong Tang1, Zheng Liu1,†(), Sijun Wu1   

  1. 1. Department of Orthopedics, Peking University Shougang Hospital, Beijing 100144, China
  • Received:2019-01-17 Published:2019-04-15
  • Corresponding author: Zheng Liu
  • About author:
    Corresponding author: Liu Zheng, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

唐冲, 刘正, 吴四军. 汉族老年人群脊柱-骨盆X线片矢状位参数特点及序列拟合关系分析[J]. 中华临床医师杂志(电子版), 2019, 13(08): 583-588.

Chong Tang, Zheng Liu, Sijun Wu. Spinopelvic sagittal parameters and their regression analysis in an elderly Han population[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(08): 583-588.

目的

通过测量我国无症状汉族老年人群的脊柱-骨盆矢状位参数，分析各参数之间的相关性以及骨盆入射角（PI）在老年人群中的变化机制，建立腰椎前凸角（LL）与PI之间的线性拟合关系。

方法

运用北京大学首钢医院图像存档和通信系统对80例志愿者的全脊柱X线片进行脊柱-骨盆矢状位各参数的测量，包括PI、骨盆倾斜角（PT）、骶骨倾斜角（SS）、LL、胸椎后凸角（TK）、脊柱骶骨角（SSA）、T9矢状位偏移角（T9SO）、脊柱矢状位平衡（SVA）。对脊柱-骨盆各参数进行Pearson相关性分析以及线性回归建立LL与PI的线性拟合关系。

结果

PI为（51.72±9.53）°，PT为（14.52±7.27）°，SS为（37.20±7.84）°，LL为（52.13±10.46）°，TK为（37.57±9.15）°，SSA为（126.72±8.21）°，T9SO为（9.96±3.09）°，SVA为（18.62±28.15）mm。PI与SS（r=0.665，P<0.001）、PT（r=0.593，P<0.001）、LL（r=0.502，P<0.001）、SSA（r=0.513，P<0.001）、SVA（r=0.290，P=0.009）呈正相关，LL与SS（r=0.840，P<0.001）、PT（r=-0.248，P=0.026）、TK（r=0.371，P=0.001）、SSA（r=0.878，P<0.001）、SVA（r=-0.258，P=0.021）有显著相关性。LL与PI的线性拟合关系为LL=0.55×PI＋24（R2=0.252）。

结论

无症状汉族老年人群的脊柱-骨盆矢状位参数之间存在显著相关性，其中PI为（51.72±9.53）°；推荐我国汉族老年人群LL与PI的线性拟合关系为LL=0.55×PI＋24，可供我国老年患者脊柱矫形手术提供策略参考。

关键词: 汉族人群, 老年, 脊柱-骨盆矢状位参数, 骨盆入射角, 腰椎前凸角, 线性回归
Objective

To analyze the correlation of spinopelvic parameters and the change mechanism of pelvic incidence angle by measuring the spinopelvic sagittal parameters of asymptomatic elderly Han people, and to establish the linear relationship between lumbar lordosis (LL) and pelvic incidence (PI).

Methods

The spinopelvic parameters of 80 volunteers were measured by global spine X-rays using the picture archiving and communication systems at Shougang Hospital of Peking University. The parameters included PI, pelvic tilt (PT), sacral slope (SS), LL, thoracic kyphosis (TK), spinosacral angle (SSA), T9 sagittal offset (T9SO), and sagittal vertical axis (SVA). Pearson correlation analysis of spinopelvic parameters was performed and the linear regression between LL and PI was assessed with SPSS 20.0 statistical software.

Results

PI, PT, SS, LL, TK, SSA, T9SO, and SVA were (51.72±9.53)°, (14.52±7.27)°, (37.20±7.84)°, (52.13±10.46)°, (37.57±9.15)°, (126.72±8.21)°, (9.96±3.09)°, and (18.62±28.15) mm, respectively. PI was significantly positively correlated with SS (r=0.665, P<0.001), PT (r=0.593, P<0.001), LL (r=0.502, P<0.001), SSA (r=0.513, P<0.001), and SVA (r=0.290, P=0.009). LL was significantly correlated with SS (r=0.840, P<0.001), PT (r=-0.248, P=0.026), TK (r=0.371, P=0.001), SSA (r=0.878, P<0.001), and SVA (r=-0.258, P=0.021). The linear regression equation between LL and PI was LL=0.55×PI+ 24 (R2=0.252).

Conclusions

There are significant correlations between spinopelvic parameters in asymptomatic elderly Han people. PI is (51.72±9.53)°. The linear regression equation between LL and PI in the Chinese elderly Han population is LL=0.55×PI+ 24, which can provide a strategic reference for spinal deformity in Chinese elderly patients.

Key words: Han population, Elderly, Spinopelvic sagittal parameters, Pelvic incidence angle, Lumbar lordosis angle, Linear regression
表1 汉族老年人群的脊柱-骨盆矢状面参数的测量值（±s）
性别 例数 PI（度） SS（度） PT（度） LL（度） TK（度） SSA（度） T9SO（度） SVA（mm）
男性 40 50.73±10.37 35.95±7.68 14.79±6.79 50.03±10.31 36.99±8.45 125.26±7.99 10.07±2.56 21.52±30.55
女性 40 52.70±8.63 38.46±7.89 14.25±7.80 54.24±10.30 38.16±9.87 128.18±8.27 9.85±3.58 15.73±25.58
合计 ? 51.72±9.53 37.20±7.84 14.52±7.27 52.13±10.46 37.57±9.15 126.72±8.21 9.96±3.09 18.62±28.15
t值 ? -0.925 -1.443 0.33 -1.825 -0.572 -1.606 0.305 0.918
P值 ? 0.358 0.153 0.742 0.072 0.569 0.112 0.761 0.361
图1~2 脊柱-骨盆矢状位参数的测量方法
图3 腰椎前凸角与骨盆入射角的线性拟合关系
表2 本研究LL、PI的线性拟合与既往文献的比较（度）
研究文献 拟合方程 拟合LL 实测LL t值 P值
本研究 LL=0.55×PI＋24 52.44±5.24 ? -0.307 0.760
Schwab等[8]? LL=PI＋9 60.72±9.53 ? -7.668 <0.001
孙卓然等[9]? LL=0.6×PI＋20 51.03±5.72 52.13±10.46 1.090 0.313
Mac-Thiong等[10]? LL=0.6×PI＋30 61.03±5.72 ? -8.782 <0.001
Hasegawa等[11]? LL=0.6×PI-0.23×age＋32.9 48.26±5.93 ? 3.820 <0.001
1
Diebo BG, Varghese JJ, Lafage R, et al. Sagittal alignment of the spine: What do you need to know?[J]. Clin Neurol Neurosurg, 2015, 139: 295-301.
2
Jackson RP, Kanemura T, Kawakami N, et al. Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain[J]. Spine (Phila Pa 1976), 2000, 25(5): 575-586.
3
Roussouly P, Gollogly S, Berthonnaud E, et al. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position[J]. Spine (Phila Pa 1976), 2005, 30(3): 346-353.
4
Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters[J]. J Spinal Disord Tech, 2005, 18(1): 40-47.
5
Boulay C, Tardieu C, Hecquet J, et al. Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis[J]. Eur Spine J, 2006, 15(4): 415-422.
6
Lafage V, Schwab F, Patel A, et al. Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity[J]. Spine (Phila Pa 1976), 2009, 34(17): E599-606.
7
Glassman SD, Berven S, Bridwell K, et al. Correlation of radiographic parameters and clinical symptoms in adult scoliosis[J]. Spine (Phila Pa 1976), 2005, 30(6): 682-688.
8
Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient[J]. Spine (Phila Pa 1976), 2009, 34(17): 1828-1833.
9
孙卓然，李危石，陈仲强, 等. 正常国人脊柱-骨盆矢状位序列拟合关系研究[J]. 中国脊柱脊髓杂志, 2015, 25(1): 1-5.
10
Mac-Thiong JM, Labelle H, Roussouly P. Pediatric sagittal alignment[J]. Eur Spine J, 2011, 20 Suppl 5: 586-590.
11
Hasegawa K, Okamoto M, Hatsushikano S, et al. Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects[J]. Eur Spine J, 2016, 25(11): 3675-3686.
12
Legaye J, Duval-Beaupère G, Hecquet J, et al. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves[J]. Eur Spine J, 1998, 7(2): 99-103.
13
Vialle R, Levassor N, Rillardon L, et al. Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects[J]. J Bone Joint Surg Am, 2005, 87(2): 260-267.
14
Noshchenko A, Hoffecker L, CMJ C, et al. Spinopelvic Parameters in Asymptomatic Subjects Without Spine Disease and Deformity: A Systematic Review With Meta-Analysis[J]. Clin Spine Surg, 2017, 30(9): 392-403.
15
Lee CS, Chung SS, Kang KC, et al. Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population[J]. Spine (Phila Pa 1976), 2011, 36(25): E1648-1654.
16
Cho Y. Evaluation of Global Sagittal Balance in Koreans Adults[J]. J Korean Neurosurg Soc, 2017, 60(5): 560-566.
17
Yang X, Kong Q, Song Y, et al. The characteristics of spinopelvic sagittal alignment in patients with lumbar disc degenerative diseases[J]. Eur Spine J, 2014, 23(3): 569-575.
18
Hu P, Yu M, Sun Z, et al. Analysis of Global Sagittal Postural Patterns in Asymptomatic Chinese Adults[J]. Asian Spine J, 2016, 10(2): 282-288.
19
Zhu Z, Xu L, Zhu F, et al. Sagittal alignment of spine and pelvis in asymptomatic adults: norms in Chinese populations[J]. Spine (Phila Pa 1976), 2014, 39(1): E1-6.
20
Yeh KT, Lee RP, Chen IH, et al. Are There Age-and Sex-related Differences in Spinal Sagittal Alignment and Balance Among Taiwanese Asymptomatic Adults?[J]. Clin Orthop Relat Res, 2018, 476(5): 1010-1017.
21
Kang KB, Kim YJ, Muzaffar N, et al. Changes of Sagittal Spinopelvic Parameters in Normal Koreans with Age over 50[J]. Asian Spine J, 2010, 4(2): 96-101.
22
Vrtovec T, Janssen MM, Likar B, et al. Evaluation of pelvic morphology in the sagittal plane[J]. Spine J, 2013, 13(11): 1500-1509.
23
Moon JW, Shinn JK, Ryu D, et al. Pelvic Incidence Can Be Changed not only by Age and Sex, but also by Posture Used during Imaging[J]. Korean J Spine, 2017, 14(3): 77-83.
24
Jean L. Influence of age and sagittal balance of the spine on the value of the pelvic incidence[J]. Eur Spine J, 2014, 23(7): 1394-1399.
25
Bao H, Liabaud B, Varghese J, et al. Lumbosacral stress and age may contribute to increased pelvic incidence: an analysis of 1625 adults[J]. Eur Spine J, 2018, 27(2): 482-488.
[1] 吴香敏, 吴鹏. 超声引导下收肌管阻滞联合腘动脉与膝关节后囊间隙阻滞在老年患者全膝关节置换术中的应用效果[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 516-522.
[2] 李凤仪, 李若凡, 高旭, 张超凡. 目标导向液体干预对老年胃肠道肿瘤患者术后血流动力学、胃肠功能恢复的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 29-32.
[3] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[4] 李婷婷, 吴荷玉, 张悦, 程康, 张晓芳, 程娅婵. 复合保温策略在老年腹腔镜解剖性肝切除术中的应用研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 522-525.
[5] 刘跃刚, 薛振峰. 腹腔镜腹股沟疝日间手术在老年患者中的安全性分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 711-714.
[6] 代格格, 杨丽, 胡媛媛, 周文婷. 手术室综合干预在老年腹股沟疝患者中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 759-763.
[7] 张汪, 徐淑英, 张爱华, 夏芬荣, 汪露. 手术室体温护理结合细节护理干预在老年腹股沟疝围手术期的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 635-638.
[8] 赵宏霞, 刘静, 李晓薇, 陈金婵, 汪志霞. 腹腔镜下经阴道子宫全切术联合阴道前后壁修补术治疗老年子宫脱垂效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 561-565.
[9] 刘政委, 仪立志, 尹夕龙, 孔文龙, 纠智松, 张文源. 锥颅血肿外引流与神经内镜手术治疗老年基底节区高血压性脑出血的疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 299-303.
[10] 单秋洁, 孙立柱, 徐宜全, 王之霞, 徐妍, 马浩, 刘田田. 中老年食管癌患者调强放射治疗期间放射性肺损伤风险模型构建及应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 388-393.
[11] 姜里蛟, 张峰, 周玉萍. 多学科诊疗模式救治老年急性非静脉曲张性上消化道大出血患者的临床观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 520-524.
[12] 郭震天, 张宗明, 赵月, 刘立民, 张翀, 刘卓, 齐晖, 田坤. 机器学习算法预测老年急性胆囊炎术后住院时间探索[J]. 中华临床医师杂志(电子版), 2023, 17(9): 955-961.
[13] 李永胜, 孙家和, 郭书伟, 卢义康, 刘洪洲. 高龄结直肠癌患者根治术后短期并发症及其影响因素[J]. 中华临床医师杂志(电子版), 2023, 17(9): 962-967.
[14] 卓徐鹏, 刘颖, 任菁菁. 感染性疾病与老年人低蛋白血症的相关性研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 896-899.
[15] 晏美娟, 邵礼晖. 高水平脂蛋白（a）与无“三高”老年人群小动脉硬化型脑小血管病的相关性研究[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 458-463.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号