骶骨形态与脊柱骨盆矢状位参数的相关性研究

Correlation study of sacral morphology and sagittal spino-pelvic alignment

中文关键词:  骶骨  脊柱骨盆参数  矢状位序列

英文关键词:Sacrum  Spino-pelvic parameters  Sagittal alignment

中文摘要:

  【摘要】 目的：探索人体骶骨形态与脊柱-骨盆矢状位参数的相关性。方法：回顾性分析132例18～35岁健康成年人自然站立位的腰骶部正侧位X线片资料，测量其腰椎前凸角（lumbar lordosis，LL）、骨盆入射角（pelvic incidence，PI）、骶骨倾斜角（sacral slope，SS）、骨盆倾斜角（pelvic tilt，PT）；采用Ferguson法测量T12、L1-L5、S1-S5、S5Co1相对S1上终板垂线的倾斜角。测量骶骨形态学参数：S1-2倾斜线与S1终板垂线夹角（S1-2T）、S1-2倾斜线与S5Co1倾斜线夹角（骶骨后凸，sacral kyphosis，SK）；S2前缘与S4Co1倾斜线夹角（α）、S1上终板与S2前缘夹角（β）、S4Co1倾斜线与S1上终板夹角（θ）。测量骶骨体位学参数：S2前缘水平角（S2HA）、S5Co1倾斜线水平角（S5Co1HA）。对相关参数进行统计学描述、相关性分析、线性回归、配对检验。结果：S2为矢状位腰骶段“端椎”；S1-2T与PI及LL相关系数分别为0.656、0.260（P<0.01）。SK与PI及LL相关系数分别为0.527、0.434（P<0.01），S1、S2倾斜角差值与下腰椎倾斜角相关；PI=35°+0.52×β-0.37×θ（R=0.87）；LL=79°-0.45×θ（R=0.52）；PI=α±10°、LL=SK±12°；SS=S2HA+1.5°±12°、S5Co1HA=91°±11°。结论：S1-2相对S1终板垂线向后倾斜程度越大，PI、LL越小，骶椎后凸程度越大，PI、LL越大；S1相对S2倾斜程度差异可反映下腰椎的前凸贡献程度；骶骨形态学参数可预测PI、LL，骶骨体位学参数可反映骨盆倾斜状态。

英文摘要:

  【Abstract】 Objectives: To explore the correlation of sacral morphology and sagittal spino-pelvic alignment. Methods: The full-length free-standing radiographs of 132 healthy adults aged from 18 to 35 were reviewed. Radiological parameters, including lumbar lordosis(LL), pelvic incidence(PI), sacral slope(SS), and pelvic tilt(PT) were measured. Ferguson method was used to measure the angle between T12, L1-L5, S1-S5, S5Co1 tilt and the vertical line of the upper endplate of S1. The sacral morphology parameters including the angle between S1-2 tilt and the vertical line of the upper end plate of S1(S1-2T), the angle between S1-2 tilt and S5Co1 tilt(sacral kyphosis, SK), the angle between the anterior edge of S2 and S4Co1 tilt (α), the upper endplate of S1 and the anterior edge of S2(β) and S4Co1 tilt and the upper endplate of S1(θ) were measured. The sacral position parameters including the horizontal angle of anterior edge of S2(S2HA) and the horizontal angle of S5Co1 tilt(S5Co1HA) were measured. Statistical methods included statistical description, correlation analysis, linear regression and paired t test. Results: S2 was the sagittal lumbo-sacral "end vertebra". The correlation between S1-2T and PI and LL was 0.656 and 0.260(P<0.01), and it was 0.527 and 0.434 between SK and PI and LL(P<0.01). The angle between S1-S5, S5Co1 tilt and the vertical line of the upper end plate of S1 were related to PI and LL; the difference of the tilt between S1 and S2 was related to the lower lumbar tilt. PI=35°+0.52×β-0.37×θ(R=0.87); LL=79°-0.45×θ（R=0.52）; PI=α±10°; LL=SK±12°; SS=S2AEHA+1.5°±12°; S5Co1HA=91°±11°. Conclusions: The degree of backward tilt of S1 and S2 are negatively correlated with PI and LL; SK is positively correlated with PI and LL; the difference of the tilt between S1 and S2 reflects the distribution of the lower lumbar spine to LL; the sacral morphology parameters could predict PI and LL, and sacral position parameters reflect pelvic tilted state.