目的 测量退行性腰椎侧凸（degenerative lumbar scoliosis，DLS）患者椎管形态学参数，分析其变化规律及其与脊柱-骨盆参数的相关性。 方法 收集DLS患者50例，分别在X线、CT及MRI上测量腰弯Cobb角、腰椎前凸角、顶椎位置、顶椎偏移距离、顶椎旋转度、顶椎侧方和前方滑移距离、骨盆投射角（pelvic incidence，PI）、骨盆倾斜角（pelvic tilt，PT）、骶骨倾斜角（sacral slope，SS）、凹侧和凸侧椎间孔高度、宽度和横截面积、硬膜囊横截面积、横径和前后径，分析椎管形态学变化规律及其与脊柱-骨盆参数的相关性。 结果 DLS患者的顶椎位于L2~L3椎体；其椎管相关参数最小处均位于L4/5节段；椎间孔相关参数最小处均位于L2/3节段。DLS患者L2/3水平椎管及椎间孔的形态学参数与年龄、腰弯Cobb角及顶椎偏移距离存在相关性（P<0.05）；而L5/S1水平椎间孔的形态学参数与PI、SS存在相关性（P<0.05）。 结论 DLS患者椎管最狭窄处多位于L4/5节段，而椎间孔最狭窄处多位于L2/3节段。顶椎区椎管狭窄程度、椎间孔狭窄程度与脊柱-骨盆参数之间存在一定的相关性。
Abstract
Objective To analyze the change pattern and its correlation with spinal-pelvic parameters by measuring morphological parameters of the spinal canal in patients with degenerative lumbar scoliosis (DLS). Methods Fifty cases of DLS patients were collected. Cobb angle of lumbar bending, anterior lumbar convexity angle, position of the parietal vertebra, distance of parietal offset, rotation of the parietal vertebra, distance of lateral and anterior slip of the parietal vertebra, pelvic parameters PI, PT, SS, height, width and cross-sectional area of the intervertebral foramen on the concave and convex sides, cross-sectional area of the dural sac, transverse diameter and anterior-posterior diameter were measured on X-ray, CT and MRI, respectively. The patterns of morphological changes in the spinal canal and their correlation with spinal-pelvic parameters were analyzed. Results The parietal vertebra of DLS patients were located in the L2~L3 vertebra. The lowest spinal canal parameters were located at L4/5 level, the lowest intervertebral foramen parameters were located at L2/3 level. Morphological parameters of the spinal canal and intervertebral foramen at the L2/3 level correlated with age, cobb angle of lumbar bending, and distance of parietal offset in patients with DLS (P<0.05); while morphological parameters of the intervertebral foramen at the L5/S1 level were correlated with PI and SS (P<0.05). Conclusions The most narrowed spinal canal in DLS patients is mostly located at the L4/5 segment, while the most narrowed intervertebral foramen is mostly located at the L2/3 segment. There is a correlation between the degree of spinal canal stenosis and foraminal stenosis in the parietal region and spinal-pelvic parameters.
关键词
退行性腰椎侧凸； /
/
椎管； /
/
椎间孔； /
/
解剖学； /
/
测量
Key words
Degenerative lumbar scoliosis; /
Spinal canal; /
Intervertebral foramen; /
Anatomy /
Measurement
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参考文献
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基金
江西省“双千计划”首批培养类项目；中央引导地方科技发展资金（No.20222ZDH04095）；江西省重点研发计划项目（No.20223BBG71S02）
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