腰椎管狭窄症脊柱-骨盆矢状位参数研究进展

doi:10.6040/j.issn.1671-7554.0.2019.070

摘要/Abstract

摘要： 腰椎管狭窄症是临床较为常见的脊柱退行性疾病,其临床症状与脊柱-骨盆矢状位参数变化密切相关,既往研究主要围绕腰椎管狭窄症矢状位参数与患者生活质量的相关性。单纯解决病变节段问题而忽视矢状位重建,可能会降低手术疗效。近年研究重点集中在不同手术方式对矢状位参数的影响。大多数腰椎管狭窄症患者术前矢状位失衡为功能性失代偿, 通过短节段减压或固定融合手术即可恢复矢状位平衡。术后未恢复平衡者与术前严重失衡相关性及其危险因素尚存在很大争议,目前研究认为其危险因素主要包括高龄及较大的骨盆入射角与腰椎前凸角的差值。手术对矢状位失衡的改善以及术后矢状位失衡与残留症状的关系有待进一步研究,且矢状位曲度与临床症状的相关性尚需要进一步探索。

关键词: 腰椎管狭窄症, 矢状位, 脊柱, 骨盆, 失平衡

Abstract: Lumbar spinal stenosis(LSS)is a common spine degenerative disease, and its clinical symptoms are closely 山东大学学报 (医学版)57卷5期 -刘新宇,等.腰椎管狭窄症脊柱-骨盆矢状位参数研究进展 \=-related to sagittal parameters of the spine and pelvis. Previous studies focused on the relationship between sagittal parameters and patients' quality of life, trying to solve the segmental problems while ignoring sagittal reconstruction; therefore, the surgical outcomes were generally impaired. In recent years, research focus has changed to the effects of different surgical methods on sagittal parameters, and found that the sagittal imbalance in most LSS patients is functional decompensated before operation, which can be restored by simple decompression or fusion surgery. So far there is still much controversy about the relationship between postoperative sagittal imbalance and preoperative imbalance as well as the risk factors. Current studies consider that the risk factors of sagittal imbalance mainly include old age and large pelvic incidence angle and 1umbar lordosis(PI-LL). The improvement of sagittal imbalance after surgery and the relationship between sagittal imbalance and residual symptoms need to be further studied, and the correlation between sagittal curvature and clinical symptoms also needs to be further explored.

Key words: Lumbar spinal stenosis, Sagittal, Spine, Pelvis, Imbalance

中图分类号:

R681.5

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.

LIU Xinyu, JIA Jun. Research advances in sagittal parameters of spine and pelvic in patients with lumbar spinal stenosis[J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 30-35.

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