【摘要】 目的通过对比骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture,OVCF）患者与无症状老年人群的脊柱-骨盆矢状位参数,探讨OVCF对患者脊柱-骨盆矢状位平衡的影响。方法选取北京大学首钢医院骨科2017年1月至2017年8月诊治的骨质疏松性椎体压缩骨折患者64例,其中男性22例,女性42例,均行术前全脊柱正侧位X线片;同期门诊招募60例无症状老年人群作为对照组,男性20例,女性40例,签订知情同意后行全脊柱正侧位X线片。运用PACS系统在124例全脊柱侧位X线片上进行脊柱-骨盆矢状位各参数的测量,包括骨盆入射角（pelvic incidence,PI）、骨盆倾斜角（pelvic tilt,PT）、骶骨倾斜角（sacral slope,SS）、腰椎前凸角（lumbar lordosis,LL）、胸椎后凸角（thoracic kyphosis,TK）、脊柱骶骨角（spinosacral angle,SSA）、脊柱矢状位平衡（sagittal vertical axis,SVA）、C₇矢状位比值（C₇ sagittal ratio,C₇/SFD）。运用SPSS 20.0统计软件进行统计学分析。结果 OVCF组和对照组的PI差异无统计学意义;OVCF组的SS、LL、SSA分别为（31.23±8.88）°、（45.48±12.59）°、（118.01±9.61）°,均显著小于对照组（P<0.01）;OVCF组的PT、TK、SVA、C₇/SFD分别为（19.75±10.46）°、（41.98±11.86）°、（34.72±40.72）mm、（0.75±1.04）,均显著大于对照组（P<0.05）。OVCF组SVA及C₇/SFD的矢状位失衡率分别为33.4%、59.4%,均显著高于对照组（P<0.01）。结论骨质疏松性压缩椎体骨折可导致脊柱-骨盆矢状位参数LL、SS、SSA减小,TK、PT、SVA、C₇/SFD增加,易发生脊柱-骨盆矢状位失衡,应积极手术矫正,恢复矢状位平衡。更多还原

【Abstract】 Objective To investigate the effect of osteoporotic vertebral compression fracture（OVCF） on the spinopelvic parameters,by comparing OVCF patients and asymptomatic elderly patients. Methods A total of 64 patients（including 22 males and 42 females） with osteoporotic vertebral compression fractures treated in Shougang Hospital from January 2017 to August 2017 were selected.All patients were performed the whole spinal lateral X-ray before operation.During the same period,60 asymptomatic elderly patients were recruited as the control group（20 males and 40 females）,and signed the informed consent and performed the whole spinal lateral X-ray.The PACS system was used to measure spinopelvic parameters in 124 cases,including pelvic incidence（PI）,pelvic tilt（PT）,sacral slope（SS）,lumbar lordosis（LL）,thoracic kyphosis（TK）,spinosacral angle（SSA）,sagittal vertical axis（SVA）,and C₇ sagittal ratio（C₇/SFD）.SPSS20.0 statistical software was used for statistical analysis. Results There was no significant difference in PI between the OVCF group and the control group.The SS,LL,and SSA of the OVCF group were（31.23±8.88）°,（45.48±12.59）°,and（118.01±9.61）°,respectively,which were significantly smaller than those in the control group（P<0.01）.The PT,TK,SVA,and C₇/SFD in the OVCF group were（19.75±10.46）°,（41.98±11.86）°,（34.72±40.72）mm,and（0.75±1.04）,respectively,which were significantly greater than those in the control group（P<0.05）.The sagittal imbalance ratios of SVA and C₇/SFD in the OVCF group were 33.4% and 59.4%,respectively,which were significantly higher than those in the control group（P<0.01）.Conclusion Osteoporotic compression vertebral fractures（OVCF） can reduce LL,SS,SSA,and increase TK,PT,SVA,C₇/SFD,which is prone to spinopelvic sagittal imbalance.Spinal deformity Surgery should be performed to restore sagittal balance.更多还原