退变性腰椎侧凸患者矢状面整体、局部影像学参数特征及患者生存质量的相关性分析

发布时间：2018-03-29 16:51

本文选题：退变性腰椎侧凸　切入点：矢状面平衡　出处：《宁夏医科大学》2017年硕士论文

【摘要】：目的:分析退变性腰椎侧凸矢状位整体、局部影像学参数的特征及各参数之间的联系;探讨影响患者健康生存质量的相关参数。方法:选取74例退变性腰椎侧凸患者,年龄50岁,性别不限。以Lenke-Silva分型为分组依据,分为轻度侧凸组和重度侧凸组,选取40例同年龄阶段的健康体检者作为对照组。在PACS图像系统中测量三组的脊柱-骨盆矢状位整体、局部影像学参数,采用SNK检验比较三组的年龄及影像学测量结果,并用Pearson相关性检验分析各参数间的相关性;对所有退变性腰椎侧凸患者进行ODI及生存质量量表SF-12问卷自评调查,采用Pearson相关性检验分析各量表评分结果与退变性腰椎侧凸患者矢状面参数的相关性。结果:多重比较检验结果显示:(1)PR-T12:对照组、轻度侧凸组与重度侧凸组之间PR-T12差异最为明显,F=11.383 P=0.0000.05,差异具有统计学意义;(2)SVA:脊柱矢状位失衡的发生率分别为:对照组2.0%,轻度侧凸组36.0%,重度侧凸组44.1%;对照组、轻度侧凸组及重度侧凸组的SVA差异具有统计学意义;(3)TK、PT、TPA:侧凸组的TK值均较对照组减小,而侧凸组的PT与TPA均较对照组显著增大,且差异均具有统计学意义。相关性分析结果显示:(1)PI与PT、SS的相关性依然存在,两套骨盆参数紧密相关;(2)LL与多个参数密切相关(相关系数r0.5)包括TK、SSA、SS、PR-T12、PR-S1,其中SSA与LL关系最为紧密,r=0.737。(3)SSA与TPA与各影像学参数的相关性明显优于SVA。HRQOL评分相关性研究显示:SVA与HRQL的相关性强于PT,同时SVA还与SF-12MCS具有较弱的相关性,r=0.192,p=0.0450.05。LL在与ODI的相关性最强,r=-0.648,p=0.0160.05。结论:1、评价退行性腰椎侧凸患者脊柱-骨盆矢状面平衡时应重视参数TPA与PR-T12。2、SVA的平衡与合理的PT值对与退变性腰椎侧凸患者的健康生存质量具有明确意义。
[Abstract]:Objective: to analyze the sagittal position of degenerative lumbar scoliosis, the characteristics of local imaging parameters and the relationship between these parameters, and to explore the relevant parameters affecting the quality of life of the patients. Methods: 74 patients with degenerative lumbar scoliosis were selected. The age of 50 years was not limited to sex. According to Lenke-Silva classification, they were divided into mild scoliosis group and severe scoliosis group. Forty healthy persons of the same age were selected as control group. The whole spine and pelvis sagittal position and local imaging parameters were measured in the PACS imaging system. The age and imaging results of the three groups were compared by SNK test. All patients with degenerative lumbar scoliosis were investigated with ODI and quality of life (QOL) SF-12 questionnaire. Pearson correlation test was used to analyze the correlation between the scores of each scale and the sagittal parameters of patients with degenerative lumbar scoliosis. The difference of PR-T12 between mild scoliosis group and severe scoliosis group was the most obvious. The difference was statistically significant (P < 0.05). The incidence of sagittal position imbalance was: control group 2.0, mild scoliosis group 36.0, severe scoliosis group 44.1. The difference of SVA between mild and severe scoliosis group was statistically significant. The TK value of scoliosis group was lower than that of control group, while PT and TPA of scoliosis group were significantly higher than that of control group. The results of correlation analysis showed that there was still a correlation between Pi and PTSS. Two sets of pelvis parameters are closely correlated with several parameters (correlation coefficient r0.5), including TKS SSASSN PR-T12PR-S1, in which SSA and LL are most closely related to each imaging parameter. The correlation between SSA and TPA is significantly better than that of SVA.HRQOL score. The correlation between HRQL and SF-12MCS is stronger than that of PT.The correlation between SVA and SF-12MCS is weaker than that between SVA and SF-12MCS. The correlation between SVA and ODI is the strongest. Conclusion: 1, in evaluating the sagittal balance of spine and pelvis in patients with degenerative lumbar scoliosis, attention should be paid to the balance of TPA and PR-T12.2 SVA in patients with degenerative lumbar scoliosis. A reasonable PT value is significant for the healthy quality of life in patients with degenerative lumbar scoliosis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.5

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