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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： 骨科学； 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:
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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/OL]. 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/OL]. 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
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