【作者】 李海波；

【导师】 陈其昕；

【作者基本信息】 浙江大学 ， 骨外科， 2011， 硕士

【摘要】 目的：探讨退行性脊柱侧凸病例骨盆形态对脊柱矢状面形态的影响。方法：对110例退行性脊柱侧凸患者和70例脊柱形态正常志愿者(年龄大于40岁)摄站立位脊柱全长正侧位片,并测量下列参数：T2～T5Cobb角、T5～T12Cobb角、T10～L2Cobb角、T12～S1Cobb角、骨盆投射角(PI)、骶骨倾斜角(SS)和骨盆倾斜角(PT)。根据SRS分型标准中矢状面退行性变修正参数,将退行性脊柱侧凸患者脊柱矢状面形态分成三组,Ⅰ组：各脊柱节段Cobb角均在SRS正常标准范围之内；Ⅱ组：T12～S1Cobb角前凸小于等于40°,其余脊柱节段Cobb角位于正常范围；Ⅲ组：T12～S1Cobb角前凸小于等于40°,T10～L2Cobb角后凸大于等于20°,其余脊柱节段Cobb角位于正常范围。比较正常对照组与各退变侧凸组间的骨盆参数,并分析不同组的骨盆参数与脊柱矢状面参数相关性。结果：(1)、正常对照组与Ⅰ组、Ⅱ组的PI值存在显著性差异,退变侧凸病例中Ⅰ组分别与Ⅱ组、Ⅲ组的PI值存在显著性差异；(2)、正常对照组与Ⅰ组、Ⅱ组、Ⅲ组的SS值均存在显著性差异；Ⅰ组分别与Ⅱ组、Ⅲ组的SS值存在显著差异性；PT值在四组间无显著性差异；(3)、正常对照组、Ⅰ组中骨盆参数与脊柱矢状面参数存在明显的相关性；(4)、Ⅱ组中骨盆参数间有相关性,但骨盆参数与脊柱矢状面参数无显著性相关；(5)、Ⅲ组中骨盆各参数间的相关性和其余脊柱矢状面参数间均无显著性相关。结论：退行性脊柱侧凸患者有2种类型的PI；且原有的脊柱矢状面力线与PT和SS关系被破坏。更多还原

【Abstract】 Objective:To investigate the cases of degenerative scoliosis of the spine sagittal pelvic morphologyMethods:110 patients with degenerative scoliosis and spine were normal volunteers,70 patients (age> 40 years) are taken standing full spine radiographs and to measure the following parameters:T2～T5Cobb angle, T5～T12Cobb angle, T10～L2Cobb angle, T12～S1Cobb angle, pelvic angle of projection (PI), sacral inclination angle (SS) and pelvic tilt (PT). Classification criteria under the SRS degenerative sagittal correction parameters, patients with degenerative scoliosis spinal sagittal split into three groups,Ⅰgroup:Cobb angle of all spinal segments were within the normal standard SRS;Ⅱgroup:T12-S1Cobb lordosis angle of less than or equal 40°, the remaining segments of the spine in the normal range of Cobb angle;ⅢGroup:T12-S1Cobb lordosis angle of less than or equal 40°, T10～L2Cobb kyphosis angle greater than or equal 20°, Cobb angle of the remaining segments of the spine in the normal range. The control group compared with the group of degenerative scoliosis between pelvic parameters, and analysis of different groups of pelvic parameters and sagittal spinal parameters of relevance.Results:(1)、the normal control group andⅠgroup,Ⅱgroup, PI values showed significant differences in degenerative scoliosis cases in I group were compared withⅡgroup,Ⅲgroup PI values were significantly different;(2)、the normal control group andⅠgroup,Ⅱgroup,Ⅲgroup SS values were significantly different;Ⅰgroup were compared withⅡgroup,Ⅲgroup of the SS value of significant differences; PT value in the four groups showed no difference;(3)、normal control group, I set parameters in the pelvis and spine sagittal obvious correlation between parameters;(4)、Ⅱgroup correlation between the pelvic parameters, but the pelvis and spine sagittal parameters were no significant correlation;(5)、Ⅲgroup, the pelvis the correlation between parameters and the parameters of the sagittal plane with the spine showed no significant correlation.Conclusion:degenerative scoliosis There are 2 types of PI; and the original lines of force of spinal sagittal relationship with the PT and SS were destroyed.更多还原