Dynamic Change of Lumbar Structure and Associated Factors: A Retrospective Study
Dynamic Change of Lumbar Structure and Associated Factors: A Retrospective Study
复制标题
腰椎结构的动态变化及相关因素：回顾性研究。
DOI：
10.1111/os.12557
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发表时间：
2019-11-03
影响因子：
2.1
通讯作者：
Zhang, Ying-ze
中科院分区：
文献类型：
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作者：
Wei, Jian-lu;Zhu, Yan-bin;Zhang, Ying-ze
目的探讨腰椎解剖参数是否处于动态变化中及其相关因素。方法回顾性研究。选择2017年10月至2019年3月在山东大学齐鲁医院进行腰椎计算机断层扫描（CT）的受试者。476名参与者被随机选择为男性或女性，年龄从17岁到87岁（平均值，55.19岁;标准差，14.28岁）。所有测量均基于CT扫描图像进行，并使用图像存档和通信系统（PACS）进行腰椎形态学测量。通过重建CT分析确定正中矢状面上水平线与椎弓根中心的夹角、正中矢状面上终板与下终板的夹角以及轴位上Magerl点的横截面角（TSA）。结果在所有参与者中，腰椎1 - 3正中矢状位上水平线与椎弓根中心之间的角度随着年龄的增长而显著降低，从3.90 ° ± 2.81 °降至-4.18 ° ± 6.86 °（P = 0.002）、5.60度+/- 2.89度至-4.14度+/- 5.90度（P = 0.030）和4.75度+/- 2.95度至-2.87度+/- 4.68度（P < 0.001）。此外，男性参与者腰椎2的正中矢状位视图上水平对齐与椎弓根中心之间的角度显著降低，从4.83度+/- 2.79度降至-4.45度+/- 5.97度（P = 0.30）。女性受试者的腰椎3度显著降低，从4.56度± 2.52度降至-2.88度± 5.03度（P = 0.029）。此外，在所有参与者中，腰椎1 - 4正中矢状位上终板与下终板之间的角度与年龄相关（分别为P < 0.001，P < 0.001，P = 0.015，P < 0.001）。男性腰1、腰2、腰4角和女性腰1 ~腰4角均与年龄相关（P < 0.05）。此外，在所有参与者中，腰椎1至3的TSA与年龄显著相关（分别为P = 0.015，P = 0.006和P = 0.007）。此外，男性受试者腰椎1至腰椎4的该角度均与年龄呈负相关（分别为P = 0.017，P = 0.001，P = 0.005和P = 0.036）。结论腰椎解剖学参数呈动态变化，并具有年龄和性别依赖性。在老年患者的脊柱手术中，应更多地关注这些解剖学变化。
Objective To determine whether lumbar anatomy parameters are in dynamic change and related factors. Methods This is a retrospective study. Participants who did lumbar computed tomography (CT) scanning in Shandong University Qilu Hospital from October 2017 to March 2019 were selected. The 476 participants were randomly selected as male or female, with the age ranging from 17 to 87 years (mean, 55.19; standard deviation, 14.28 years). All the measurements were taken based on the CT scanning image and the measurement of lumbar morphology was conducted using picture archiving and communication systems (PACS). The angle between the horizontal alignment and pedicle center on median sagittal view, the angle between upper endplate and lower endplate on median sagittal view as well as transverse section angle (TSA) using Magerl point in the axial view was determined by reconstructive CT analysis. Results In the overall participants, the angle between the horizontal alignment and pedicle center on median sagittal view of lumbar one to three was significantly decreased with aging, from 3.90 degrees +/- 2.81 degrees to -4.18 degrees +/- 6.86 degrees (P = 0.002), 5.60 degrees +/- 2.89 degrees to -4.14 degrees +/- 5.90 degrees (P = 0.030), and 4.75 degrees +/- 2.95 degrees to -2.87 degrees +/- 4.68 degrees (P < 0.001), respectively. Additionally, the angle between the horizontal alignment and pedicle center on median sagittal view in male participants of lumbar two was dramatically decreased, from 4.83 degrees +/- 2.79 degrees to -4.45 degrees +/- 5.97 degrees (P = 0.30). And that of lumbar three in female participants was significantly decreased, from 4.56 degrees +/- 2.52 degrees to -2.88 degrees +/- 5.03 degrees (P = 0.029). Furthermore, of the overall participants, the angle between upper endplate and lower endplate on median sagittal view of lumbar one to four was associated with aging (P < 0.001, P < 0.001, P = 0.015, P < 0.001, respectively). The angle of lumbar one, two and four in male participants and lumbar one to four in female participants were all significantly related to aging (all P < 0.05). Moreover, in the participants overall, the TSA of lumbar one to three was significantly associated with aging (P = 0.015, P = 0.006 and P = 0.007, respectively). In addition, this angle in lumbar one to lumbar four in male participants were all negatively associated with aging (P = 0.017, P = 0.001, P = 0.005 and P = 0.036, respectively). Conclusion Lumbar anatomy parameters are in dynamic change in an age and gender dependent manner. During spine surgery in elderly patients, more attention should be paid to these anatomic changes.