| 青少年L5S1发育性滑脱与峡部裂性滑脱的脊柱骨盆矢状面形态比较 |
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投稿时间：2018-05-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 李子恢 |
LI Zi-hui |
南京医科大学, 江苏 南京 210029 |
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| 陈曦 |
CHEN Xi |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 孙旭 |
SUN Xu |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 王斌 |
WANG Bin |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 朱泽章 |
ZHU Ze-zhang |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 钱邦平 |
QIAN Bang-ping |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 刘臻 |
LIU Zhen |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 俞杨 |
YU Yang |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 邱勇 |
QIU Yong |
南京医科大学鼓楼临床医学院脊柱外科, 江苏 南京 210008 |
Department of Spinal Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
Scoliosis2002@sina.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第3期，第234-238页 |
| DOI：10.3969/j.issn.1003-0034.2019.03.008 |
| 基金项目: |
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中文摘要:
目的：比较青少年L5S1发育不良性滑脱与峡部裂性滑脱的脊柱骨盆矢状面形态特点。
方法：对2002年5月至2016年12月收治的24例影像资料完整的青少年L5S1滑脱患者的病例资料进行回顾性分析。男8例，女16例，年龄10~18（13.4±2.0）岁；其中发育不良性滑脱（发育不良组）9例，峡部裂性滑脱（峡部裂组）15例。在站立位脊柱侧位片上测量滑脱相关指标（滑移距离、滑脱率、滑脱角）和脊柱骨盆矢状面形态指标（矢状面偏移、胸椎后凸角、腰椎前凸角、L5入射角、骨盆入射角、骨盆倾斜角、骶骨倾斜角、骨盆矢状面厚度、腰骶角、骶骨平台角）。对两组影像学参数进行统计学分析。
结果：两组患者的滑脱距离、滑脱率和滑脱角差异无统计学意义。发育性滑脱组矢状面偏移、L5入射角、骨盆倾斜角和骨盆矢状面厚度均明显高于峡部裂性滑脱组（P<0.05）。发育性滑脱组的骶骨倾斜角、腰骶角和骶骨平台角则显著低于峡部裂性滑脱组（P<0.05）。两组间胸椎后凸角和腰椎前凸角差异无统计学意义（P>0.05）。
结论：与峡部裂性滑脱明显不同，发育不良性滑脱表现为躯干前倾明显，骨盆后倾。对于发育不良性滑脱，需要严密观察，出现矢状面失平衡时则应早期手术干预。 |
| 【关键词】青少年 腰椎滑脱症 发育不良 峡部裂 外科手术 影像学 |
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| Comparison of sagittal plane morphology of spine and pelvis in adolescents with L5S1 developmental spondylolisthesis and isthmic spondylolisthesis |
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ABSTRACT
Objective:To compare the sagittal morphological features of the spine and pelvis between L5S1 dysplastic spondylolisthesis and isthmus spondylolisthesis in adolescent.
MethodsRetrospective analysis of 24 cases of adolescent L5S1 spondylolisthesis with complete imaging data from May 2002 to December 2016. Those included 8 males and 16 females,aged from 10 to 18 years old with an average of (13.4±2.0) years. Among them,9 cases were diagnosed as dysplastic spondylolisthesis (dysplasia group) and 15 cases isthmic spondylolisthesis (ischemic group). Radiographic parameters including slippage distance,slippage degree,slippage angle,sagittal vertical axis(SVA),thoracic kyphosis(TK),lumbar lordosis(LL),L5 incidence(L5I),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),sagittal pelvic thickness(SPT),lumbosacral angle (LSA),sacral table angle (STA) were measured on the spinal lateral X-ray of the standing position. Independent-samples t-test was used in the comparison of each variable between two groups. P<0.05 was considered statistically significant.
ResultsThere were no significant differences in slippage distance,slippage rate,slippage angle between two groups. In dysplasia group,SVA,L5I,PT,SPT were (37.0±48.4) mm,(57.0±14.8)°,(42.3±15.4)°,(56.1±21.2) mm,respectively,and (-11.0±22.2) mm,(31.7±19.3) °,(15.5±10.2)°,(31.4±19.1) mm in ischemic group;and the differences between the two groups were significant(P<0.05). In ischemic group,SS,LSA,STA were (44.1±12.6)°,(103.9±21.7)°,(92.7±9.9)°,respectively,and (25.9±20.2) °,(75.4±16.4) °,(75.4±9.7) ° in dysplasia group;and the differences between the two groups were significant(P<0.05). There was no significant difference in TK,LL between two groups(P>0.05).
ConclusionSignificant different from isthmic spondylolisthesis,adolescents with dysplastic spondylolisthesis present a different spino-pelvic sagittal alignment,characterized with trunk forward leaning and pelvic retroversion. In case of sagittal imbalance,early surgical intervention is required to restore a balanced spino-pelvic alignment. |
| KEY WORDS Adolescent Spondylolisthesis Dysplastic Isthmic Surgical procedures,operative Imaging |
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| 中文格式: | 李子恢,陈曦,孙旭,王斌,朱泽章,钱邦平,刘臻,俞杨,邱勇.青少年L5S1发育性滑脱与峡部裂性滑脱的脊柱骨盆矢状面形态比较[J].中国骨伤,2019,32(3):234~238 |
| 英文格式: | LI Zi-hui,CHEN Xi,SUN Xu,WANG Bin,ZHU Ze-zhang,QIAN Bang-ping,LIU Zhen,YU Yang,QIU Yong.Comparison of sagittal plane morphology of spine and pelvis in adolescents with L5S1 developmental spondylolisthesis and isthmic spondylolisthesis[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(3):234~238 |
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