Degenerative Disease Characteristics And Clinical Significance Of Pelvic Spine Sagittal Parameter

Objective:1. To explore the pelvic spine sagittal parameter characteristics of lumbar degenerative disease.2. To research the relationship between the Lumbar degenerative disease and spinal pelvic coordinate loss.Methods:1. From January2011to June2013period selected among hospitalized cases that meet the research needs of160cases, divided into4groups, group A:40cases of degenerative lumbar disc herniation, group B:40cases of isthmic spondylolisthesis, group C:40patients with degenerative lumbar spondylolisthesis, group D:40cases of lumbar vertebrae disease-free volunteers. On lateral radiographs of the spine measuring PI (pelvic incidenc), SS (sacral slope),PT (pelvic tiit), LL (lumbar lordosis), TK (thoracic kyphosis), LA (lumbar angle), LIT (L1tilting angle), SSA (spine-sacral angle), SFD (Sacro-femoral distance) and SC7D(The horizontal distance between C7Plumb Line and the posterior corner of the sacrum), and calculate SC7D/SFD ratios. Compare the set of pelvic spine sagittal parameter characteristics.2. To the first part of spinal parameter value and the pelvis parameter value carry on the relevant analysis, comparison of lumbar degenerative disease group with no lumbar diseases such as spinal pelvic coordinate differences that exist between the groups.Results:1. Analysis and comparison of four groups of parameters values by Oneway ANOVA differences statistically significantly (P<0.01). Compared with the D group:A, B and C groups SC7D, SC7D/SFD, L1T;A group, LL, LA, SSA;B groups, PI,SS;C groups, PI, PT difference statistically significantly (P<0.01).2. The group parameter between Pearson relevance analysis:D group SSA, LL, LA and PI, SS relevance strong (P<0.01), SC7D,SC7D/SFD and PI,L1T and SS related (P<0.05); A group SSA, LL, LA and PI;B group SC7D, SC7D/SFD and PI; C group SC7D, SC7D/SFD,LA and PI; A,B and C three group LIT and SS relevance disappear (P>0.05).Conclusion:1. Degenerative diseases spinal pelvic sagittal parameter characteristics:1) Normal spinal sagittal parameter value changes, fluctuation range large, clinical significance for a single parameter values is small.2) Parameters SC7D, SC7D/SFD and LIT union application have larger clinical significance, its reference value is in turn for-8.25mm,0.4±1,-7.46°.In the basic unit hospital where Is not having the condition to photograph entire spinal column piece, may survey LIT on the lumbar vertebra X piece to assess the change of the lumbar position.3) The value of SC7D, SC7D/SFD and LIT in three sets of lumbar degeneration cases are larger than in the normal, change from a negative to positive values, the C7plumb line, the LI center shifted forward, the lumbar spine is tilted forward.4) In degenerative lumbar disc herniation, LL,LA and SSA less than normal, lumbar curvature is small, L3tilt small, spine tilted forward are the characteristic performance. In degenerative spondylolisthesis,PI, PT values are great. In isthmic spondylolisthesis, PI, PT,SS are larger.5)Main difference is size of LL in three lumbar disease, LL in degenerative lumbar disc herniation is the smallest, followed by degenerative spondylolisthesis and isthmic spondylolisthesis with Max.2. The relationship between lumbar degenerative disease and spinal pelvic coordinate loss.Under normal state spine and pelvis exists matching and coordination of anatomical morphology and position, spinal parameter and pelvis parameter existence certain relevance, the relevance between SSA, LL, LA, SC7D, SC7D/SFD and PI, L1T and SS is the most important. In the degenerative lumbar disease spine and pelvis appear uncoordinated, but in different disease the spine and pelvis uncoordinated performance are not the same, showed the correlation between the different spinal parameters and the pelvic parameters decreased, or even disappear. There was a linear correlation between LL and PI, SS, the function relation was LL=0.5PI+28°, LL=0.8SS+23°, the formula can be applied in clinical, provide reference for the lumbar degenerative disease diagnosis and lumbar lordosis angle correction prediction of lumbar operation.