The cohort study for the determination of reference values for spinopelvic parameters (T1 pelvic angle and global tilt) in elderly volunteers
The cohort study for the determination of reference values for spinopelvic parameters (T1 pelvic angle and global tilt) in elderly volunteers
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DOI：
10.1007/s00586-016-4411-x
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发表时间：
2016-11-01
影响因子：
2.8
通讯作者：
Matsuyama, Yukihiro
中科院分区：
文献类型：
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作者：
Banno, Tomohiro;Togawa, Daisuke;Matsuyama, Yukihiro
T1骨盆角(TPA)和整体倾斜度(GT)是影响躯干前倾和骨盆后倾的骨盆脊柱参数。为了解日本成年人的脊柱骨盆参数，特别是TPA和GT，并确定与健康相关生活质量(HRQOL)相关的各项参数的常模。656名志愿者(男262名，女394名)年龄50-92岁，平均72.8岁。观察椎体骨折、腰椎滑脱和冠状错位的发生率。采用全脊柱站立位X线片测量骨盆5个参数(TPA、GT、矢状面垂直轴[SVA]、骨盆倾斜度[PT]和骨盆入射角-腰椎前凸[PI-LL])。每个参数的平均值是按性别和寿命估计的。还获得了包括奥斯维斯蒂残疾指数(ODI)和EuroQuol-5D(EQ-5D)在内的HRQOL测量。确定各参数与HRQOL测评的相关系数。此外，以年龄、性别、脊柱骨折和腰椎滑脱、冠状错位(冠状曲线30A度)和矢状位错位(SVA>；95 mm)为解释变量，以残疾(ODI>；40)为自由变量，用Logistic回归方法计算了影响QOL评分的因素。脊柱骨盆参数的平均值如下：TPA为17.9A度；GT为23.2A度；SVA为50.2 mm；PT为18.6A度；PI-LL为7.5A度。TPA和GT之间呈强相关(r=0.990)，并与其他脊柱骨盆参数呈显著正相关。TPA和GT分别与ODI(r=0.339，r=0.348)和EQ-5D(r=-0.285，r=-0.288)呈正相关，与SVA的相关性相似。女性的TPA、GT、PT和PI-LL显著高于男性。PT和PI-LL随年龄增长而逐渐增加，而TPA、GT和SVA在第7个十年后趋于恶化。Logistic回归分析显示，矢状位错位对ODI的恶化影响最大。基于线性回归模型的重度残疾(ODI>；40)的TPA和GT分界值分别为26.0A度和33.7A度。与SVA相似，TPA、GT与HRQOL呈正相关。女性的TPA、GT、PT和PI-LL较差，且随年龄增长而加重。
T1 pelvic angle (TPA) and global tilt (GT) are spinopelvic parameters that account for trunk anteversion and pelvic retroversion. To investigate spinopelvic parameters, especially TPA and GT, in Japanese adults and determine norms for each parameter related to health-related quality of life (HRQOL).Six hundred and fifty-six volunteers (262 men and 394 women) aged 50-92 years (mean, 72.8 years) were enrolled in this study. The incidence of vertebral fracture, spondylolisthesis and coronal malalignment were measured. Five spinopelvic parameters (TPA, GT, sagittal vertical axis [SVA], pelvic tilt [PT], and pelvic incidence-lumbar lordosis [PI-LL]) were measured using whole spine standing radiographs. The mean values for each parameter were estimated by sex and decade of life. HRQOL measures, including the Oswestry Disability Index (ODI) and EuroQuol-5D (EQ-5D), were also obtained. Pearson's correlation coefficients were determined between each parameter and HRQOL measure. Moreover, the factors contributing to the QOL score were calculated using logistic regression with age, sex, the existence of vertebral fracture and spondylolisthesis, coronal malalignment (coronal curve > 30A degrees) and sagittal malalignment (SVA > 95 mm) as explanatory variables and the presence of disability (ODI > 40) as a free variable.The mean values for the spinopelvic parameters were as follows: TPA, 17.9A degrees; GT, 23.2A degrees; SVA, 50.2 mm; PT, 18.6A degrees; and PI-LL, 7.5A degrees. TPA and GT strongly correlated with each other (r = 0.990) and with the other spinopelvic parameters. TPA and GT correlated with ODI (r = 0.339, r = 0.348, respectively) and EQ-5D (r = -0.285, r = -0.288, respectively), similar to those for SVA. TPA, GT, PT, and PI-LL were significantly higher in women than in men. PT and PI-LL gradually increased with age, while TPA, GT, and SVA tended to deteriorate after the 7th decade. Based on a logistic regression analysis, the deterioration of ODI was mostly affected by the sagittal malalignment. The TPA and GT cut-off values for severe disability (ODI > 40) based on linear regression modeling were 26.0A degrees and 33.7A degrees, respectively.We determined reference values for spinopelvic parameters in elderly volunteers. Similar to SVA, TPA and GT correlated with HRQOL. TPA, GT, PT, and PI-LL were worse in women and progressed with age.