【摘要】 目的探讨腰椎管狭窄症(Degenerative lumbar spinal stenosis,DLSS)伴或不伴退行性腰椎滑脱(Degenerative spondylolisthesis,DS)的步态特征。方法选择2017年1月～2019年1月在本院就诊的74例DLSS患者,观察伴DS和不伴DS患者的步态特征。结果伴DS和不伴DS患者性别、年龄、体质量指数、腰痛和下肢痛视觉模拟评分(Visual analogue scales,VAS)等一般资料相比较,差异均无统计学意义(P>0.05)。DS组腰椎前凸高于非DS组,差异有统计学意义(P<0.05); 2组患者椎体尺寸、骶骨前倾角相比较,差异均无统计学意义(P>0.05)。足跟接触(Heel contact,HC)时DS组和非DS组患者步速、步长、着陆距离(Touch distance,TD)、释放距离(Release distance,RD)、髋关节角度、膝关节角度、踝关节角度相比较,差异均无统计学意义(P>0.05),步峰上COM至COM之间的距离(distance between upper COM and COM,U-COM)和下COM至COM之间的距离(distance between lower COM and COM,L-COM)存在统计学差异(P<0.05),着力侧髋关节角度、膝关节角度、踝关节角度相比较,差异均无统计学意义(P>0.05)。脚趾离地(Toe off,TO)时,DS和非DS患者步侧髋关节角度、膝关节角度、踝关节角度水平相比较,差异均无统计学意义(P>0.05),U-COM和L-COM存在统计学差异(P<0.05),着力侧DS和非DS患者髋关节角度、膝关节角度、踝关节角度相比较,差异均无统计学意义(P>0.05)。结论 DLSS伴DS患者上、下COM距人体重心距离较长,步态时重心在矢状面上向后倾斜,对其康复训练计划制定中需要考虑患者的步态特征。更多还原

【Abstract】 Objective To investigate the gait characteristics of degenerative lumbar spinal stenosis( DLSS) with or without degenerative spondylolisthesis( DS). Methods From January 2017 to January 2019,74 patients with DLSS were selected to observe the gait characteristics of DS and non-DS patients. Results There were no significant differences in gender,age,body mass index,visual analogue scales( VAS),leg pain VAS between DS and non-DS patients( P>0.05).The lumbar lordosis in DS group was higher than that in non-DS group( P<0.05),and there were no significant differences in vertebral size and sacral anteversion between the two groups( P>0.05). There were no significant differences between DS group and non-DS group in step speed,step length,touch distance( TD),release distance( RD),hip joint angle,knee joint angle and ankle joint angle( P>0.05). There was no significant difference between COM and COM( U-C). The distance between upper COM and COM( U-COM) and distance between lower COM and COM( L-COM) had statistically significant difference( P<0.05). There were no significant differences in the angle of hip joint,knee joint and ankle joint between exertion side( P>0.05).There were no significant differences in hip angle,knee angle and ankle angle between DS and non-DS patients when toe off( TO) was performed( P>0.05). There was significant difference between U-COM and L-COM( P<0.05). There were no significant differences in hip angle,knee angle and ankle angle between DS and non-DS patients( P > 0.05).Conclusion For patients with DLSS and DS,the distance between upper and lower COM and the center of gravity is longer,and the center of gravity is inclined backward on sagittal plane. The gait characteristics of DLSS patients with DS should be considered in the rehabilitation training plan.更多还原