Evaluation effect of C7 pelvic angle on degenerative scoliosis
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摘要:
目的 探讨基于改良SVA的颈椎骨盆角（CPA）是否更好的评价退变性脊柱侧凸（DS）患者脊柱-骨盆矢状面平衡情况，探讨CPA与DS患者生存质量的相关性。 方法 整理我院自2010年2月~2017年1月接诊并实施手术治疗的DS患者资料，共67例纳入研究。术前及末次随访时均摄站立位全脊柱正、侧位X线片，同时填写VAS、ODI及SRS-22量表。 结果 术前SVA、C7/SFD与矢状面平衡参数相关性弱于CPA；末次随访时CPA与矢状面平衡参数相关性强于SVA、C7/SFD；术前SVA、C7/SFD、CPA各与术前VAS、ODI、SRS-22存在相关性（P<0.05），CPA与之相关性更强。术前、末次随访时CPA变化值与生存质量评分变化值的相关性强于SVA变化值。 结论 CPA整合了整体和局部脊柱-骨盆矢状面平衡的信息，能够反映DS患者脊柱-骨盆矢状面的整体及局部平衡，且与DS患者的生存质量密切相关，对于DS重建手术有着重要的指导意义。 -
关键词:
- 退变性脊柱侧凸 /
- 脊柱-骨盆矢状面平衡 /
- 颈椎骨盆角 /
- 生存质量
Abstract:Objectives To explore whether C7 pelvic angle can evaluate the sagittal balance, and investigate the relationship between CPA and health related quality of life of patients with degenerative scoliosis (DS). Methods Data of DS patients who received surgical treatment in our hospital from February 2010 to January 2017 were retrospectively analyzed. A total of 67 DS patients were included (7 male, 60 females). Results The correlation between preoperative SVA, C7/SFD and sagittal plane balance parameters was weaker than CPA. At the last follow-up, the correlation between CPA and sagittal equilibrium parameters was stronger than that between SVA and C7/SFD. Preoperative SVA, C7/SFD and CPA were correlated with VAS, ODI and SRS-22 (P<0.05), and CPA was more correlated with them. The correlation between CPA and health related quality of life score was stronger than SVA at preoperative and final follow-up. Conclusion CPA can better reflect spinal-pelvic sagittal balance and health related quality of life, and the guiding significance of DS reconstructive surgery is more important. -
图 1 矢状面整体平衡的测量参数
CPA:C7 颈椎骨盆角, C7中点与S1上终板后上角连线与C7铅垂线的夹角；SVA: 矢状面垂直轴, 测量方法为C7铅垂线与S1上终板后缘的水平距离；SFD: 骶股距, S1后上角至两股骨头中心中点的水平距离.
表 1 各测量指标的术前及末次随访数据统计
指标 术前 术前 改变值 PI（Mean±SD, °） 44.23±7.06（29.8~74） 44.34±6.89（29.3~74.1） − PT（Mean±SD, °） 22.19±5.50（10.6~40.6） 16.06±3.54（4~28.3） − SS（Mean±SD, °） 22.03±4.96（12.4~35.6） 28.28±3.97（21.6~45.8） − LL（Mean±SD, °） 22.55±10.43（–5.7~49.6） 35.03±8.14（10.8~52） − TK（Mean±SD, °） 16.49±9.89（2.5~48.9） 24.49±9.89（10.8~56.9） − VAS（Mean±SD） 6.85±0.82（5~9） 2.93±0.76（1~5） 3.75±1.21（0~7） ODI（Mean±SD, %） 79.79±5.51（68~90） 40.93±4.87（30~58） 37.34±6.84（20~50） SRS-22（Mean±SD ） 56.18±7.77（41~76） 70.88±11.23（48~107） 14.71±7.02（3~32） SVA（Mean±SD, cm） 5.71±2.24（1.7~12） 2.37±1.55（0~8.7） 3.34±1.54（0.4~8） C7/SFD（Mean±SD） 1.29±2.26（0~3.8） 0.37±3.27（0~1.4） − CPA（Mean±SD, °） 5.94±2.92（1~14.8） 2.11±1.24（0~6.5） 3.84±2.25（0.2~12.6） 
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