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Medical Diagnosis 2024
脊柱–骨盆参数在腰椎滑脱中的研究进展
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Abstract:
腰椎滑脱是一种临床常见的可导致下腰痛及下肢症状的疾病，术后下腰痛的症状是否与脊柱–骨盆矢状位参数变化相关的临床关联问题日益引起临床关注，既往人们对脊柱骨盆参数的研究侧重于长节段脊柱融合术后影响的研究，且研究较为充分并有相对统一的结论，但对短节段腰椎融合术后影响的研究较少且存在一定争议，笔者下文以腰椎滑脱为例试图阐述短节段腰椎融合术后临床症状与矢状位参数之间的关系并进行综述。
Lumbar spondylolisthesis is a common clinical disease that can lead to low back pain and lower ex-tremity symptoms. The clinical correlation between postoperative low back pain symptoms and the change of spinal and pelvic sagittal position parameters has attracted increasing clinical attention. Previous studies on spinal and pelvic parameters have focused on the study on the postoperative effects of long-level spinal fusion, and the studies have been relatively sufficient and reached rela-tively uniform conclusions. However, there are few and controversial studies on the postoperative effects of short level lumbar fusion. In the following article, the author takes lumbar spondylolisthe-sis as an example to attempt to elaborate the relationship between clinical symptoms and sagittal position parameters after short level lumbar fusion.
| [1] | Golder, W. (1982) Spondyl—Olisthesis mehr als ein Etymologisches Problem [Spondyl-Olisthesis More Than a Problem of Etymology]. Rontgenblatter, 35, 111. |
| [2] | Fredrickson, B.E., Baker, D., McHolick, W.J., Yuan, H.A. and Lubicky, J.P. (1984) The Natural History of Spondylolysis and Spondylolisthesis. The Journal of Bone & Joint Surgery, 66, 699-707.
https://doi.org/10.2106/00004623-198466050-00008 |
| [3] | Bydon, M., Alvi, M.A. and Goyal, A. (2019) Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurgery Clin-ics of North America, 30, 299-304.
https://doi.org/10.1016/j.nec.2019.02.003 |
| [4] | Bhalla, A. and Bono, C.M. (2019) Isthmic Lumbar Spondylolisthesis. Neurosurgery Clinics of North America, 30, 283-290. https://doi.org/10.1016/j.nec.2019.02.001 |
| [5] | 脊柱外科学[J]. 中国微创外科杂志, 2014, 14(6): 550. |
| [6] | Vrtovec, T., Janssen, M.M., Likar, B., Castelein, R.M., Viergever, M.A. and Pernu？, F. (2012) A Review of Methods for Evaluating the Quantitative Parameters of Sagittal Pelvic Alignment. The Spine Journal, 12, 433-446.
https://doi.org/10.1016/j.spinee.2012.02.013 |
| [7] | Faundez, A., Roussouly, P. and Le Huec, J.C. (2011) Analyse de l’équilibre Sagittal du Rachis. Une Révolution Dans Les Approches Thérapeutiques des Pathologies Dégénératives Lombaires [Sagittal Balance of the Spine: A Therapeutic Revolution]. Revue Médicale Suisse, 7, 2470-2474. |
| [8] | 刘新宇, 贾军. 腰椎管狭窄症脊柱-骨盆矢状位参数研究进展[J]. 山东大学学报(医学版), 2019, 57(5): 30-35, 42. |
| [9] | Legaye, J., Du-val-Beaupère, G., Hecquet, J. and Marty, C. (1998) Pelvic Incidence: A Fundamental Pelvic Parameter for Three-Dimensional Regulation of Spinal Sagittal Curves. European Spine Journal, 7, 99-103.
https://doi.org/10.1007/s005860050038 |
| [10] | Bao, H., Liabaud, B., Varghese, J., Lafage, R., Diebo, B.G., Jalai, C., Ram-chandran, S., Poorman, G., Errico, T., Zhu, F., Protopsaltis, T., Passias, P., Buckland, A., Schwab, F. and Lafage, V. (2018) Lumbosacral Stress and Age May Contribute to Increased Pelvic Incidence: An Analysis of 1625 Adults. European Spine Journal, 27, 482-488.
https://doi.org/10.1007/s00586-017-5324-z |
| [11] | Jean, L. (2014) Influence of Age and Sagittal Balance of the Spine on the Value of the Pelvic Incidence. European Spine Journal, 23, 1394-1399. https://doi.org/10.1007/s00586-014-3207-0 |
| [12] | Cecchinato, R., Redaelli, A., Martini, C., Morselli, C., Villafa？e, J.H., Lamartina, C. and Berjano, P. (2017) Long Fusions to S1 with or without Pelvic Fixation Can Induce Relevant Acute Variations in Pelvic Incidence: A Retrospective Cohort Study of Adult Spine Deformity Surgery. European Spine Journal, 26, 436-441.
https://doi.org/10.1007/s00586-017-5154-z |
| [13] | Le Huec, J.C., Thompson, W., Mohsinaly, Y., Barrey, C. and Faundez, A. (2019) Sagittal Balance of the Spine. European Spine Journal, 28, 1889-1905. https://doi.org/10.1007/s00586-019-06083-1 |
| [14] | Lafage, V., Schwab, F., Patel, A., Hawkinson, N. and Farcy, J.P. (2009) Pelvic Tilt and Truncal Inclination: Two Key Radiographic Parameters in the Setting of Adults with Spinal Deformity. Spine, 34, E599-E606.
https://doi.org/10.1097/BRS.0b013e3181aad219 |
| [15] | Yang, M., Yang, C., Zhai, X., Zhao, J., Zhu, X. and Li, M. (2017) Analysis of Factors Associated with Sagittal Balance in Normal Asymptomatic Individuals: A Retrospective Study in a Popula-tion of East China. Spine, 42, E219-E225.
https://doi.org/10.1097/BRS.0000000000001782 |
| [16] | Barrey, C., Roussouly, P., Le Huec, J.C., D’Acunzi, G. and Perrin, G. (2013) Compensatory Mechanisms Contributing to Keep the Sagittal Balance of the Spine. European Spine Journal, 22, S834-S841.
https://doi.org/10.1007/s00586-013-3030-z |
| [17] | Berthonnaud, E., Dimnet, J., Roussouly, P. and Labelle, H. (2005) Anal-ysis of the Sagittal Balance of the Spine and Pelvis Using Shape and Orientation Parameters. Journal of Spinal Disorders & Techniques, 18, 40-47.
https://doi.org/10.1097/01.bsd.0000117542.88865.77 |
| [18] | Hanson, D.S., Bridwell, K.H., Rhee, J.M. and Lenke, L.G. (2002) Correlation of Pelvic Incidence with Low- and High-Grade Isthmic Spondylolisthesis. Spine, 27, 2026-2029.
https://doi.org/10.1097/00007632-200209150-00011 |
| [19] | Schwab, F., Lafage, V., Patel, A. and Farcy, J.P. (2009) Sagit-tal Plane Considerations and the Pelvis in the Adult Patient. Spine, 34, 1828-1833. https://doi.org/10.1097/BRS.0b013e3181a13c08 |
| [20] | Simper, L.B. (1986) Spondylolysis in Eskimo Skeletons. Acta or-thopaedica Scandinavica, 57, 78-80.
https://doi.org/10.3109/17453678608993222 |
| [21] | Lonner, B.S., Auerbach, J.D., Sponseller, P., Rajadhyaksha, A.D. and Newton, P.O. (2010) Variations in Pelvic and Other Sagittal Spinal Parameters as a Function of Race in Adolescent Idiopathic Scoliosis. Spine, 35, E374-E377.
https://doi.org/10.1097/BRS.0b013e3181bb4f96 |
| [22] | Zhu, Z., Xu, L., Zhu, F., Jiang, L., Wang, Z., Liu, Z., Qian, B.P. and Qiu, Y. (2014) Sagittal Alignment of Spine and Pelvis in Asymptomatic Adults: Norms in Chinese Populations. Spine, 39, E1-E6.
https://doi.org/10.1097/BRS.0000000000000022 |
| [23] | Ganju, A. (2002) Isthmic Spondylolisthesis. Neurosurgical Focus, 13, 1-6. https://doi.org/10.3171/foc.2002.13.1.2 |
| [24] | Janssen, M.M., Drevelle, X., Humbert, L., Skalli, W. and Castelein, R.M. (2009) Differences in Male and Female Spino-Pelvic Alignment in Asymptomatic Young Adults: A Three-Dimensional Analysis Using Upright Low-Dose Digital Biplanar X-Rays. Spine, 34, E826-E832. https://doi.org/10.1097/BRS.0b013e3181a9fd85 |
| [25] | Vialle, R., Levassor, N., Rillardon, L., Templier, A., Skalli, W. and Guigui, P. (2005) Radiographic Analysis of the Sagittal Alignment and Balance of the Spine in Asymptomatic Subjects. The Journal of Bone & Joint Surgery, 87, 260-267. https://doi.org/10.2106/JBJS.D.02043 |
| [26] | Mac-Thiong, J.M., Roussouly, P., Berthonnaud, E. and Guigui, P. (2011) Age- and Sex-Related Variations in Sagittal Sacropelvic Morphology and Balance in Asymptomatic Adults. European Spine Journal, 20, Article No. 572.
https://doi.org/10.1007/s00586-011-1923-2 |
| [27] | Hasegawa, K., Okamoto, M., Hatsushikano, S., Shimoda, H., Sato, Y. and Watanabe, K. (2020) Etiology and Clinical Manifestations of Double-Level versus Single-Level Lumbar Degenerative Spondylolisthesis. Journal of Orthopaedic Science, 25, 812-819. https://doi.org/10.1016/j.jos.2019.11.004 |
| [28] | Hammerberg, E.M. and Wood, K.B. (2003) Sagittal Profile of the Elderly. Journal of Spinal Disorders & Techniques, 16, 44-50. https://doi.org/10.1097/00024720-200302000-00008 |
| [29] | Hikata, T., Watanabe, K., Fujita, N., Iwanami, A., Hosogane, N., Ishii, K., Nakamura, M., Toyama, Y. and Matsumoto, M. (2015) Im-pact of Sagittal Spinopelvic Alignment on Clinical Outcomes after Decompression Surgery for Lumbar Spinal Canal Stenosis without Coronal Imbalance. Journal of Neurosurgery: Spine, 23, 451-458.
https://doi.org/10.3171/2015.1.SPINE14642 |
| [30] | Shin, E.K., Kim, C.H., Chung, C.K., Choi, Y., Yim, D., Jung, W., Park, S.B., Moon, J.H., Heo, W. and Kim, S.M. (2017) Sagittal Imbalance in Patients with Lumbar Spinal Stenosis and Outcomes af-ter Simple Decompression Surgery. The Spine Journal, 17, 175-182. https://doi.org/10.1016/j.spinee.2016.08.023 |
| [31] | Dohzono, S., Toyoda, H., Matsumoto, T., Suzuki, A., Terai, H. and Nakamura, H. (2015) The Influence of Preoperative Spinal Sagittal Balance on Clinical Outcomes after Microendoscopic Lam-inotomy in Patients with Lumbar Spinal Canal Stenosis. Journal of Neurosurgery: Spine, 23, 49-54. https://doi.org/10.3171/2014.11.SPINE14452 |
| [32] | Chaléat-Valayer, E., Mac-Thiong, J.M., Paquet, J., Berthonnaud, E., Siani, F. and Roussouly, P. (2011) Sagittal Spino-Pelvic Alignment in Chronic Low Back Pain. European Spine Journal, 20, Article No. 634.
https://doi.org/10.1007/s00586-011-1931-2 |
| [33] | 郭新虎, 李危石, 郭昭庆, 等. 高度发育不良性腰椎滑脱复位程度与脊柱-骨盆矢状位参数变化的关系[J]. 中国脊柱脊髓杂志, 2020, 30(8): 679-686. |
| [34] | Jia, J., Zhao, Y. and Liu, X. (2019) Impact of Sagittal Imbalance Correction on Clinical Outcomes in Patients Undergoing MIS-TLIF for LSS. Clinical Neurology and Neurosurgery, 181, 119-126.
https://doi.org/10.1016/j.clineuro.2019.04.017 |
| [35] | Liu, H., Shrivastava, S.R., Zheng, Z.M., Wang, J.R., Yang, H., Li, Z.M., Wang, T.P., Wang, H. and Utsab, S. (2013) [Correlation of Lumbar Disc Degeneration and Spinal-Pelvic Sagittal Bal-ance]. Chinese Medical Journal, 93, 1123- 1128. |
| [36] | Abbas, J., Hamoud, K., May, H., Hay, O., Medlej, B., Masharawi, Y., Peled, N. and Hershkovitz, I. (2010) Degenerative Lumbar Spinal Stenosis and Lumbar Spine Configuration. European Spine Journal, 19, 1865-1873.
https://doi.org/10.1007/s00586-010-1516-5 |
| [37] | Schwab, F., Ungar, B., Blondel, B., Buchowski, J., Coe, J., Deinlein, D., DeWald, C., Mehdian, H., Shaffrey, C., Tribus, C. and Lafage, V. (2012) Scoliosis Research Society-Schwab Adult Spinal De-formity Classification: A Validation Study. Spine, 37, 1077-1082. https://doi.org/10.1097/BRS.0b013e31823e15e2 |
| [38] | Schwab, F., Patel, A., Ungar, B., Farcy, J.P. and Lafage, V. (2010) Adult Spinal Deformity-Postoperative Standing Imbalance: How Much Can You Tolerate? An Overview of Key Parameters in Assessing Alignment and Planning Corrective Surgery. Spine, 35, 2224-2231. https://doi.org/10.1097/BRS.0b013e3181ee6bd4 |
| [39] | Lim, J.K. and Kim, S.M. (2014) Comparison of Sagittal Spinopelvic Alignment between Lumbar Degenerative Spondylolisthesis and Degenerative Spinal Stenosis. Journal of Korean Neurosurgi-cal Society, 55, 331-336.
https://doi.org/10.3340/jkns.2014.55.6.331 |
| [40] | Rose, P.S., Bridwell, K.H., Lenke, L.G., Cronen, G.A., Mulconrey, D.S., Buchowski, J.M. and Kim, Y.J. (2009) Role of Pelvic Incidence, Thoracic Kyphosis, and Patient Factors on Sagittal Plane Cor-rection Following Pedicle Subtraction Osteotomy. Spine, 34, 785-791. https://doi.org/10.1097/BRS.0b013e31819d0c86 |
| [41] | Booth, K.C., Bridwell, K.H., Lenke, L.G., Baldus, C.R. and Blanke, K.M. (1999) Complications and Predictive Factors for the Successful Treatment of Flatback Deformity (Fixed Sagittal Imbal-ance). Spine, 24, 1712-1720.
https://doi.org/10.1097/00007632-199908150-00013 |
| [42] | Aoki, Y., Nakajima, A., Takahashi, H., Sonobe, M., Terajima, F., Saito, M., Takahashi, K., Ohtori, S., Watanabe, A., Nakajima, T., Takazawa, M., Orita, S., Eguchi, Y. and Nakagawa, K. (2015) Influence of Pelvic Incidence-Lumbar Lordosis Mismatch on Surgical Outcomes of Short-Segment Transforaminal Lumbar Interbody Fusion. BMC Musculoskeletal Disorders, 16, Article No. 213. https://doi.org/10.1186/s12891-015-0676-1 |
| [43] | Hikata, T., Watanabe, K., Fujita, N., Iwanami, A., Hosogane, N., Ishii, K., Nakamura, M., Toyama, Y. and Matsumoto, M. (2015) Impact of Sagittal Spinopelvic Alignment on Clinical Outcomes after Decompression Surgery for Lumbar Spinal Canal Stenosis without Coronal Imbalance. Journal of Neurosurgery: Spine, 23, 451-458.
https://doi.org/10.3171/2015.1.SPINE14642 |
| [44] | Fujii, K., Kawamura, N., Ikegami, M., Niitsuma, G. and Kunogi, J. (2015) Radiological Improvements in Global Sagittal Alignment after Lumbar Decompression without Fusion. Spine, 40, 703-709.
https://doi.org/10.1097/BRS.0000000000000708 |
| [45] | 孙祥耀, 张希诺, 海涌. 退变性脊柱侧凸术后骨盆投射角与腰椎前凸角匹配程度与临床疗效的关系[J]. 中国骨与关节杂志, 2017, 6(1): 20-26. |
| [46] | 赵耀, 漆龙涛, 李淳德, 等. 骨盆腰椎匹配值与成人退变性脊柱侧凸畸形术后疗效的相关性研究[J]. 中国脊柱脊髓杂志, 2016, 26(8): 701-708. |
| [47] | Schwab, F.J., Blondel, B., Bess, S., Hostin, R., Shaffrey, C.I., Smith, J.S., Boachie-Adjei, O., Burton, D.C., Akbarnia, B.A., Mundis, G.M., Ames, C.P., Kebaish, K., Hart, R.A., Farcy, J.P., Lafage, V. and International Spine Study Group (ISSG) (2013) Radiographical Spinopelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Pro-spective Multicenter Analysis. Spine, 38, E803-E812. https://doi.org/10.1097/BRS.0b013e318292b7b9 |
