Abstract:Objective To investigate the effects of osteoporosis on the sagittal spinepelvic parameters in elderly patients.Methods 115 patients with osteoporosis received from the osteoporosis specialist outpatient clinic of Department of Orthopedics in Union Hospital of Tongji Medical College from June 2020 to June 2021 were selected as the observation group.21 males and 94 females were included.The age ranged form 58 to 79,with an average age of (67.76±9.17)years.60 patients without osteoporosis who came to our hospital for health examination during the same period were selected as the control group including 18 males and 42 females.The age ranged form 54 to 76,with an average age of (65.25±10.38)years.Low-radiation X-ray machine was used to take lateral X-rays of the spine including the hip joint in the standing position to assess the spine-pelvic sagittal morphology.Thoracic kyphosis(TK),lumbar lordosis(LL),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS)and the sagittal vertical axis(SVA)were measured.The intraclass correlation coefficient(ICC)was used to evaluate the reliability of the intraobserver and interobserver.The spinepelvic sagittal parameters of the two groups were compared to analyze the effects of osteoporosis on the sagittal spine-pelvis parameters in elderly patients.Results The intra-observer and inter-observer ICC were 0.90~0.95.There were significant differences between the observation group and the control group in SVA,SS,PT,LL and TK (P<0.05).PI of the observation group was not statistically different from that of the control group(P>0.05).Conclusion The sagittal spinopelvic parameters in elderly patients change mainly in SVA,SS,PT,LL and TK after osteoporosis,while the PI is relatively constant.
[1]薛梅,骆正富.老年性骨质疏松症的发病机理、X线诊断与治疗探讨[J].浙江临床医学,2002,4(7):522-523.
[2]柴波,冯皓宇,常强,等.中国各地区绝经后骨质疏松症患病率及骨密度测量检出率分析[J].实用骨科杂志,2020,26(09):792-796.
[3]李兴国,邓叶龙,刘朝晖,等.中国老年髋部骨折流行性病学特征分析[J].实用骨科杂志,2021,27(07):601-606.
[4]韩晓斌,王建光,田明,等.脊柱矢状位参数在骨质疏松性椎体压缩骨折治疗中的价值[J].北京生物医学工程,2021,40(4):413-417.
[5]娄义姣,王安素,马炎,等.骨质疏松症与肌少症相关性研究进展[J].护理研究,2021,35(18):3251-3257.
[6]Glassman SD,Bridwell K,Dimar JR,et al.The impact of positive sagittal balance in adult spinal deformity[J].Spine,2005,30(18):2024-2029.
[7]Savage JW,Patel AA.Fixed Sagittal Plane Imbalance[J].Global spine journal,2014,4(4):287-296.
[8]胡俊,钱邦平,邱勇,等.60岁以上脊柱畸形患者脊柱-骨盆矢状面参数与生活质量的相关性分析[J].中国脊柱脊髓杂志,2016,26(8):682-688.
[9]周子玉.退变性腰椎滑脱与腰椎管狭窄症在脊柱骨盆矢状位参数之间的差异[D].宁夏:宁夏医科大学,2017.
[10]张英健,陈晨,王国强,等.脊柱骨盆矢状面平衡参数应用于成人脊柱畸形中的研究进展[J].中国中医骨伤科杂志,2020,28(12):83-88.
[11]唐冲,刘正,吴四军.骨质疏松性椎体压缩骨折对脊柱-骨盆矢状位参数影响的研究[J].实用骨科杂志,2019,25(5):385-388.
[12]Obeld I,Boissiere L,Yilgor C,et al.Global tilt:A single parameter incorporating spinal and pelvic sagittal parameters and least affected by patient positioning[J].Eur Spine J,2016,25(11):3644-3649.
[13]马剑雄,匡明杰,何伟伟,等.肌肉减少症与骨质疏松的相关性:研究与应用[J].中国组织工程研究,2018,22(32):5222-5227.
[14]王志伟,韩森东.Roussouly分型及脊柱骨盆矢状位平衡参数与骨质疏松性椎体骨折预后的相关性分析[J].临床外科杂志,2021,29(1):58-60.
[15]唐真静.脊柱骨盆矢状位参数和腰椎退变节段的相关性研究[D].辽宁:大连医科大学,2019.
[16]吴文坚,梁裕,曹鹏,等.腰椎微创侧路椎体间融合术改善成人退变性脊柱侧弯的矢状面平衡疗效分析[J].中华医学杂志,2020,100(3):192-196.
[17]Lee JS,Shin JK,AN SJ,et al.Correlation between clinical outcomes and spinopelvic parameters in osteoporosis[J].Acta orthopaedica Belgica,2014,80(4):522-528.
[18]胡宗杉,马鸿儒,钱至恺,等.基于年龄和性别的中国正常成年人脊柱-骨盆矢状位形态的多中心研究[J].中华骨科杂志,2021,41(13):844-855.
[19]Saddik H,Pinti A,Antoun A,et al.Limb muscular strength and bone mineral density in elderly subjects with low skeletal muscle mass index[J].J Clin Densitom,2021,24(4):538-547.
[20]Mika A,Unnithan VB,Mika P.Differences in thoracic kyphosis and in back muscle strength in women with bone loss due to osteoporosis[J].Spine(Phila Pa 1976),2005,30(2):241-6.
[21]Turgay T,kida MA,Karadeniz PG,et al.Vertebral fractures and spinopelvic parameters in patients with osteoporosis[J].J Surg Med,2020,4(1):53-57.
[22]Fechtenbaum J,Etcheto A,Kolta S,et al.Sagittal balance of the spine in patients with osteoporotic vertebral fractures[J].Osteoporos Int,2016,27(2):559-67