山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (5): 13-17.doi: 10.6040/j.issn.1671-7554.0.2019.236
赵杰,张凯,陈辰
ZHAO Jie, ZHANG Kai, CHEN Chen
摘要: 脊柱-骨盆矢状面平衡参数是目前脊柱外科关注的热点,但其生物力学机制国内外尚未得到明确阐释。伴随腰椎退行性疾病发病率的增加,腰椎矢状力线分析研究表明,多种腰椎退行性疾病与矢状面失衡密切相关,恢复重建生理曲度是维持正常腰椎生物力学功能的基础。研究生理状态下的腰椎矢状序列特点及其退变趋势可以帮助医生从病理状态的腰椎序列逆推,通过手术重建生理状态的腰椎矢状力线,可能有益于减轻邻近节段退变。然而,腰椎矢状位退变过程中受到多种因素影响,脊柱代偿机制复杂,目前的认识还很有限,未来有待更多的脊柱骨盆参数及矢状位力线的研究。
中图分类号:
| [1] Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010[J]. Lancet, 2013, 381(9882):1987-2015. [2] Chen RQ, Hosogane N, Watanabe K, et al. Reliability analysis of spino-pelvic parameters in adult spinal deformity: a comparison of whole spine and pelvic radiographs[J]. Spine, 2016, 41(4): 320-327. [3] Tian H, Wu A, Guo M, et al. Adequate restoration of disc height and segmental lordosis by lumbar interbody fusion decreases adjacent segment degeneration[J]. World Neurosurg, 2018, 118: 856-864. doi: 10.1016/j.wneu. [4] 龚克. 正常人群腰椎椎间高度指数、椎间角度、腰椎前凸角的研究分析及椎间高度指数与椎间盘 Pfirrmann分级的相关性研究[D]. 西安: 中国人民解放军空军军医大学, 2018. [5] Celestre PC, Dimar JR, Glassman SD. Spinopelvic parameters: lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope: what does a spine surgeon need to know to plan a lumbar deformity correction?[J]. Neurosurg Clin N Am, 2018, 29(3): 323-329. [6] Hayden AM, Hayes AM, Brechbuhler JL, et al. The effect of pelvic motion on spinopelvic parameters[J]. Spine J, 2018, 18(1): 173-178. [7] Roussouly P, Gollogly S, Berthonnaud E, et al. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position[J]. Spine, 2005, 30(3): 346-353. [8] Lee CS, Chung SS, Kang KC, et al. Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population[J]. Spine, 2011, 36(25): 1648-1654. [9] Dolphens M, Cagnie B, Coorevits P, et al. Classification system of the sagittal standing alignment in young adolescent girls[J]. Eur Spine J, 2014, 23(1): 216-225. [10] Yang M, Guo H, Wang X, et al. The morphology of sagittal alignment in asymptomatic volunteers of East China: A novel radiological classification[J]. J Orthop Sci, 2017, 22(6): 1015-1020. [11] Laouissat F, Sebaaly A, Gehrchen M, et al. Classification of normal sagittal spine alignment: refounding the Roussouly classification[J]. Eur Spine J, 2018, 27(8): 2002-2011. [12] Zhang F, Zhang K, Tian HJ, et al. Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults[J]. J Orthop Surg Res, 2018, 13(1): 34. [13] 王力, 邱南海, 余铭. 椎弓根钉固定加椎间融合修复腰椎滑脱症: 恢复椎间隙高度与否对脊柱序列及功能的影响[J]. 中国组织工程研究, 2017, 21(35): 5636-5643. WANG Li, QIU Nanhai, YU Ming. Pedicle fixation combined with intervertebral fusion for lumbar spondylolithesis: whether restoring disc height affects the biomechanics and spinal function[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(35): 5636-5643. [14] Umehara S, Zindrick MR, Patwardhan AG, et al. The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments[J]. Spine, 2000, 25(13): 1617-1624. [15] Keorochana G, Taghavi CE, Lee KB, et al. Effect of sagittal alignment on kinematic changes and degree of disc degeneration in the lumbar spine: an analysis using positional MRI[J]. Spine, 2011, 36(11): 893-898. [16] Cheng X, Zhang F, Zhang K, et al. Effect of single-level transforaminal lumbar interbody fusion on segmental and overall lumbar lordosis in patients with lumbar degenerative disease[J]. World Neurosurg, 2018, 109: 244-251. doi: 10.1016/j.wneu. [17] Jabońska-SudoK, Maciejczak A. Relationship between the spino-pelvic parameters and the slip grade in isthmic spondylolisthesis[J]. Neurol Neurochir Pol, 2015, 49(6): 381-388. [18] Agius R, Galea R, Fava S. Bone mineral density and intervertebral disc height in type 2 diabetes[J]. J Diabetes Complications, 2016, 30(4): 644-650. [19] Teichtahl AJ, Urquhart DM, Wang Y, et al. A Dose-response relationship between severity of disc degeneration and intervertebral disc height in the lumbosacral spine[J]. Arthritis Res Ther, 2015, 17: 297. doi: 10.1186/s13075-015-0820-1. [20] Barrey C, Roussouly P, Le Huec JC, et al. Compensatory mechanisms contributing to keep the sagittal balance of the spine[J]. Eur Spine J, 2013, 22(Suppl 6): 834-841. [21] Cheng X, Zhang K, Sun X, et al. Analysis of compensatory mechanisms in the pelvis and lower extremities in patients with pelvic incidence and lumbar lordosis mismatch[J]. Gait & Posture, 2017, 56: 14-18. doi: 10.1016/j.gaitpost. [22] Terran J, Schwab F, Shaffrey CI, et al. The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort[J]. Neurosurgery, 2013, 73(4): 559-568. [23] Ha KY, Jang WH, Kim YH, et al. Clinical relevance of the srs-schwab classification for degenerative lumbar scoliosis[J]. Spine, 2016, 41(5): 282-288. [24] Sebaaly A, Grobost P, Mallam L, et al. Description of the sagittal alignment of the degenerative human spine[J]. Eur Spine J, 2018, 27(2): 489-496. [25] Zhao X, Du L, Xie Y, et al. Effect of lumbar lordosis on the adjacent segment in transforaminal lumbar interbody fusion: a finite element analysis[J]. World Neurosurg, 2018, 114: 114-120. doi: 10.1016/j.wneu. |
| [1] | 机器人辅助经椎间孔腰椎椎体间融合术手术技术专家组. 机器人辅助经椎间孔腰椎椎体间融合术专家共识[J]. 山东大学学报 (医学版), 2026, 64(2): 11-21. |
| [2] | 王建民,李晓峰,由志涛,董圣杰,赵宇驰,李占菊,邹德鑫,张剑锋,孙涛,杜伟. 基于可解释机器学习的后路腰椎椎体间融合术后慢性疼痛风险预测模型构建[J]. 山东大学学报 (医学版), 2026, 64(2): 78-88. |
| [3] | 胡冰涛,张文灿,王崇怡,林翔宇,王凯斌,冯运泽,刘郴,徐万龙,李乐,司海朋. 基于加速康复外科理念的单孔分体内镜微创技术治疗腰椎管狭窄症的临床效果分析[J]. 山东大学学报 (医学版), 2025, 63(3): 1-7. |
| [4] | 刘金波,刘凯文,向崇鑫,程雷. 西红花苷对椎间盘退变的保护作用[J]. 山东大学学报 (医学版), 2023, 61(9): 84-93. |
| [5] | 徐荣坤,王连雷,原所茂,田永昊,刘新宇. 腰椎术中腹主动脉损伤1例并文献复习[J]. 山东大学学报 (医学版), 2023, 61(6): 121-124. |
| [6] | 赵赓,王连雷,王宏卫,刘新宇. 不同负重方式对腰椎生物力学的影响[J]. 山东大学学报 (医学版), 2023, 61(6): 70-78. |
| [7] | 赵赓,买若鹏,赵景才,刘新宇. 中国人适应性腰椎微创通道:基于CT影像学测量下的解剖数据分析[J]. 山东大学学报 (医学版), 2023, 61(3): 90-96. |
| [8] | 王政,孙小刚,李超,王连雷,李冬来,原所茂,田永昊,刘新宇. 机器人辅助MIS-TLIF与徒手开放TLIF治疗腰椎退行性疾病的比较:2年随访[J]. 山东大学学报 (医学版), 2023, 61(3): 97-106. |
| [9] | 朱超,孙超,刘绪昌,夏大伟,马春骋,丰荣杰. 3D打印椎间融合器在37例单节段腰椎手术中的应用[J]. 山东大学学报 (医学版), 2023, 61(3): 134-140. |
| [10] | 冯世庆. 计算机视觉与腰椎退行性疾病[J]. 山东大学学报 (医学版), 2023, 61(3): 1-6. |
| [11] | 张景良, 刘新宇, 原所茂, 王连雷. 髋关节疾病合并腰椎退行性疾病(髋腰综合征)误诊误治的原因分析[J]. 山东大学学报 (医学版), 2022, 60(5): 67-73. |
| [12] | 李明波,黄燕波,任东成,刘俊城,谭成双,徐继禧,丁金勇. 3种不同的腰椎内固定融合方式的有限元分析[J]. 山东大学学报 (医学版), 2022, 60(1): 55-64. |
| [13] | 丁金勇,徐继禧,谭成双,刘俊城,李明波,谢炜星,任东成. 不同关节突关节不对称衡量标准的有限元评价[J]. 山东大学学报 (医学版), 2020, 58(6): 97-103. |
| [14] | 邱贵兴. 腰椎疾患诊治新进展[J]. 山东大学学报 (医学版), 2019, 57(5): 1-2. |
| [15] | 姜建元,王洪立. 退变性脊柱侧凸相关分型及选择策略[J]. 山东大学学报 (医学版), 2019, 57(5): 3-6. |
|
||