脊柱-骨盆矢状位参数与腰椎融合术预后相关性的研究进展

doi:10.11958/20241580

天津医药 ›› 2025, Vol. 53 ›› Issue (1): 103-107.doi: 10.11958/20241580

脊柱-骨盆矢状位参数与腰椎融合术预后相关性的研究进展

江泽华¹(), 崔皓竣², 张伯裕¹, 任志帅¹, 马钧峰¹, 张洪杰³, 朱如森¹^,^△()

1 天津市人民医院脊柱外科（邮编300121）
2 天津医科大学人民医院临床学院
3 德宏州人民医院骨科

收稿日期:2024-10-18 修回日期:2024-11-21 出版日期:2025-01-15 发布日期:2025-02-06
通讯作者: ^△E-mail：zrsspine@163.com
作者简介:江泽华（1983），男，主治医师，主要从事脊柱脊髓疾病的基础与临床研究。E-mail：jiangzehua88@aliyun.com
基金资助:
天津市卫生健康委员会科技项目青年项目(TJWJ2022QN040)

Research progress on the correlation between sagittal spinopelvic parameters and the prognosis of lumbar fusion surgery

JIANG Zehua¹(), CUI Haojun², ZHANG Boyu¹, REN Zhishuai¹, MA Junfeng¹, ZHANG Hongjie³, ZHU Rusen¹^,^△()

1 Department of Spine Surgery, Tianjin Union Medical Center, Tianjin 300121, China
2 Department of Spine Surgery, Tianjin Union Medical Center, Tianjin Medical University
3 Department of Spine Surgery, Dehong People’s Hospital

Received:2024-10-18 Revised:2024-11-21 Published:2025-01-15 Online:2025-02-06
Contact: ^△E-mail：zrsspine@163.com

江泽华, 崔皓竣, 张伯裕, 任志帅, 马钧峰, 张洪杰, 朱如森. 脊柱-骨盆矢状位参数与腰椎融合术预后相关性的研究进展[J]. 天津医药, 2025, 53(1): 103-107.

JIANG Zehua, CUI Haojun, ZHANG Boyu, REN Zhishuai, MA Junfeng, ZHANG Hongjie, ZHU Rusen. Research progress on the correlation between sagittal spinopelvic parameters and the prognosis of lumbar fusion surgery[J]. Tianjin Medical Journal, 2025, 53(1): 103-107.

摘要/Abstract

摘要：

腰椎融合术是腰椎退行性疾病常用的外科干预、治疗手段之一。腰椎融合术后少部分患者仍然留有或出现下腰痛等并发症。脊柱-骨盆参数与腰椎融合术后患者并发症的发生紧密相关。该文回顾了常用腰椎内固定融合手术技术和主流脊柱-骨盆矢状位参数，并综述了脊柱-骨盆矢状位参数与包括下腰痛在内的多种术后并发症关系的相关研究进展及现状。

关键词: 腰椎, 椎间盘退行性变, 脊柱融合术, 腰痛, 手术后并发症, 脊柱-骨盆矢状位参数

Abstract:

lumbar fusion surgery is one of the commonly used surgical interventions and treatments for lumbar degenerative diseases. A small proportion of patients still experience complications such as low back pain after lumbar fusion surgery. Spinal-pelvic parameters are closely related to the occurrence of complications in patients after lumbar fusion surgery. This article reviews the commonly used lumbar fixation and fusion surgical techniques and mainstream sagittal spinal-pelvic parameters. Additionally, it summarizes the research progress and current status regarding the relationship between sagittal spinal-pelvic parameters and various postoperative complications, including low back pain.

Key words: lumbar vertebrae, intervertebral disc degeneration, spinal fusion, lumbago, postoperative complications, sagittal spinal-pelvic parameters

中图分类号:

R681.5

参考文献 45

[1]	XUE C, LU X, SUN G, et al. Opportunistic prediction of osteoporosis in patients with degenerative lumbar diseases:a simplified T12 vertebral bone quality approach[J]. J Orthop Surg Res, 2024, 19(1):296. doi:10.1186/s13018-024-04782-0.
[2]	YIJIAN Z, HAO L, HUILIN Y, et al. Comparison of posterolateral fusion and posterior lumbar interbody fusion for treatment of degenerative spondylolisthesis:analysis of spino-pelvic sagittal balance and postoperative chronic low back pain[J]. Clin Neurol Neurosurg, 2018, 171:1-5. doi:10.1016/j.clineuro.2018.04.020.
[3]	MADKOURI R, BRAUGE D, VIDON-BUTHION A, et al. Improvement in sagittal balance after decompression surgery without fusion in patients with degenerative lumbar stenosis:clinical and radiographic results at 1 year[J]. World Neurosurg, 2018, 114:e417-e424. doi:10.1016/j.wneu.2018.03.002.
[4]	TONG J, CHEN D, LI J, et al. Evaluating the efficacy and suggesting technical optimizations for endoscopic lumbar interbody fusion across different lumbar spondylolisthesis types[J]. Heliyon, 2024, 10(11):e32576. doi:10.1016/j.heliyon.2024.e32576.
[5]	LU T, SUN Z, XIA H, et al. Comparing the osteogenesis outcomes of different lumbar interbody fusions(A/O/X/T/PLIF)by evaluating their mechano-driven fusion processes[J]. Comput Biol Med, 2024,171:108215. doi:10.1016/j.compbiomed.2024.108215.
[6]	FU P, XU W, XU P, et al. Relationship between spinal imbalance and knee osteoarthritis by using full-body EOS[J]. BMC Musculoskelet Disord, 2023, 24(1):402. doi:10.1186/s12891-023-06508-5.
[7]	LEGAYE J, DUVAL-BEAUPèRE G, HECQUET J, et al. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves[J]. Eur Spine J, 1998, 7(2):99-103. doi:10.1007/s005860050038.
[8]	GUTMAN G, LABELLE H, BARCHI S, et al. Normal sagittal parameters of global spinal balance in children and adolescents:a prospective study of 646 asymptomatic subjects[J]. Eur Spine J, 2016, 25(11):3650-3657. doi:10.1007/s00586-016-4665-3.
[9]	BODIN A, ROUSSOULY P. Sacral and pelvic osteotomies for correction of spinal deformities[J]. Eur Spine J, 2015, 24(Suppl 1):S72-82. doi:10.1007/s00586-014-3651-x.
[10]	YOKOYAMA K, KAWANISHI M, YAMADA M, et al. Age-related variations in global spinal alignment and sagittal balance in asymptomatic Japanese adults[J]. Neurol Res, 2017, 39(5):414-418. doi:10.1080/01616412.2017.1296654.
[11]	YANG M, YANG C, ZHAI X, et al. Analysis of factors associated with sagittal balance in normal asymptomatic individuals:a retrospective study in a population of East China[J]. Spine(Phila Pa 1976), 2017, 42(4):E219-E225. doi:10.1097/BRS.0000000000001782.
[12]	BARREY C, ROUSSOULY P, LE HUEC J C, et al. Compensatory mechanisms contributing to keep the sagittal balance of the spine[J]. Eur Spine J, 2013, 22(Suppl 6):S834-S841. doi:10.1007/s00586-013-3030-z.
[13]	DELSOLE E M, VIGDORCHIK J M, SCHWARZKOPF R, et al. Total hip arthroplasty in the spinal deformity population:does degree of sagittal deformity affect rates of safe zone placement,instability,or revision?[J]. J Arthroplasty, 2017, 32(6):1910-1917. doi:10.1016/j.arth.2016.12.039.
[14]	BLACKWELL R D, PARLAMAS S, DUNBAR N J, et al. Pelvic tilt affects superolateral coverage,but not superomedial coverage of the femoral head following periacetabular osteotomy[J]. Clin Biomech(Bristol), 2024,111:106160. doi:10.1016/j.clinbiomech.2023.106160.
[15]	YI L, HOUWEI L, LIN W, et al. Evaluation of correlation between sagittal balance and plantar pressure distributions in adolescent idiopathic scoliosis:a pilot study[J]. Clin Biomech(Bristol), 2021,83:105308. doi:10.1016/j.clinbiomech.2021.105308.
[16]	VERHAEGEN J, INNMANN M, ALVES BATISTA N, et al. Defining "Normal" static and dynamic spinopelvic characteristics:a cross-sectional study[J]. JB JS Open Access, 2022, 7(3):e22.00007. doi:10.2106/JBJS.OA.22.00007.
[17]	PIERREPONT J, HAWDON G, MILES B P, et al. Variation in functional pelvic tilt in patients undergoing total hip arthroplasty[J]. Bone Joint J, 2017, 99-B(2):184-191. doi:10.1302/0301-620X.99B2.BJJ-2016-0098.R1.
[18]	INNMANN M M, MERLE C, PHAN P, et al. Differences in spinopelvic characteristics between hip osteoarthritis patients and controls[J]. J Arthroplasty, 2021, 36(8):2808-2816. doi:10.1016/j.arth.2021.03.031.
[19]	KLEEMAN-FORSTHUBER L, VIGDORCHIK J M, PIERREPONT J W, et al. Pelvic incidence significance relative to spinopelvic risk factors for total hip arthroplasty instability[J]. Bone Joint J, 2022, 104-B(3):352-358. doi:10.1302/0301-620X.104B3.BJJ-2021-0894.R1.
[20]	CHO M, HAN J S, KANG S, et al. Biomechanical effects of different sitting postures and physiologic movements on the lumbar spine:a finite element study[J]. Bioengineering(Basel), 2023, 10(9):1051. doi:10.3390/bioengineering10091051.
[21]	KIM K T, LEE S H, HUH D S, et al. Restoration of lumbar lordosis in flat back deformity:optimal degree of correction[J]. Asian Spine J, 2015, 9(3):352-360. doi:10.4184/asj.2015.9.3.352.
[22]	马清伟, 李危石, 孙卓然, 等. 中老年人群脊柱-骨盆矢状位参数及其序列拟合关系[J]. 中国脊柱脊髓杂志, 2016, 26(2):146-150.
	MA Q W, LI W S, SUN Z R, et al. Spino-pelvic sagittal parameters in middle-aged and elderly Chinese:measurements and correlationship[J]. Chinese Journal of Spine and Spinal Cord, 2016, 26(2):146-150. doi:10.3969/j.issn.1004-406X.2016.02.08.
[23]	BESS S, SCHWAB F, LAFAGE V, et al. Classifications for adult spinal deformity and use of the scoliosis research society-schwab adult spinal deformity classification[J]. Neurosurg Clin N Am, 2013, 24(2):185-193. doi:10.1016/j.nec.2012.12.008.
[24]	SCHWAB F J, BLONDEL B, BESS S, et al. Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity:a prospective multicenter analysis[J]. Spine(Phila Pa 1976), 2013, 38(13):E803-E812. doi:10.1097/BRS.0b013e318292b7b9.
[25]	INAMI S, MORIDAIRA H, TAKEUCHI D, et al. Optimum pelvic incidence minus lumbar lordosis value can be determined by individual pelvic incidence[J]. Eur Spine J, 2016, 25(11):3638-3643. doi:10.1007/s00586-016-4563-8.
[26]	OLIVEIRA T L, SILVA F D, FILHO A, et al. Relationship between spinal structural damage and sagittal balance in axial spondyloarthritis: is the thoracic spine the starting point?[J]. Semin Arthritis Rheum, 2024,65:152415. doi:10.1016/j.semarthrit.2024.152415.
[27]	BOUKNAITIR J B, CARREON L Y, BRORSON S, et al. Change in sagittal alignment after decompression alone in patients with lumbar spinal stenosis without significant deformity:a prospective cohort study[J]. J Neurosurg Spine, 2022, 37(1):57-63. doi:10.3171/2021.10.SPINE21445.
[28]	KANEKO A, NAITO K, NAGURA N, et al. Characteristics of sagittal spine alignment in female patients with distal radius fractures due to fall[J]. Heliyon, 2020, 6(8):e04756. doi:10.1016/j.heliyon.2020.e04756.
[29]	SHERRINGTON C, FAIRHALL N J, WALLBANK G K, et al. Exercise for preventing falls in older people living in the community[J]. Cochrane Database Syst Rev, 2019, 1(1):CD012424. doi:10.1002/14651858.CD012424.pub2.
[30]	LIU Y, LI X, DOU X, et al. Correlational analysis of three-dimensional spinopelvic parameters with standing balance and gait characteristics in adolescent idiopathic scoliosis:A preliminary research on Lenke V[J]. Front Bioeng Biotechnol, 2022,10:1022376. doi:10.3389/fbioe.2022.1022376.
[31]	NIU S, YANG H, GAO J, et al. Correlation between sagittal parameters and disability of patients with nonspecific chronic low back pain:a cross-sectional study of 435 subjects[J]. Spine J, 2024, 24(4):634-643. doi:10.1016/j.spinee.2023.11.004.
[32]	KALIDINDI K, BANSAL K, VISHWAKARMA G, et al. New onset sacroiliac joint pain after transforaminal interbody fusion:what are the culprits?[J]. Global Spine J, 2023, 13(3):677-682. doi:10.1177/21925682211003852.
[33]	XU H W, FANG X Y, CHEN H, et al. The effects of abdominal obesity and sagittal imbalance on sacroiliac joint pain after lumbar fusion[J]. Pain Physician, 2024, 27(1):59-67.
[34]	LEONE A, GUGLIELMI G, CASSAR-PULLICINO V N, et al. Lumbar intervertebral instability:a review[J]. Radiology, 2007, 245(1):62-77. doi:10.1148/radiol.2451051359.
[35]	CHEN C, TANG Y, YANG S, et al. Relationship between paravertebral muscle function, pelvic incidence,and health-related quality of life in patients with degenerative spinal deformity[J]. Journal of Orthopaedic Surgery and Research, 2024, 19(1):102. doi:10.1186/s13018-024-04593-3.
[36]	SHIN M H, RYU K S, HUR J W, et al. Comparative study of lumbopelvic sagittal alignment between patients with and without sacroiliac joint pain after lumbar interbody fusion[J]. Spine(Phila Pa 1976), 2013, 38(21):E1334-E1341. doi:10.1097/BRS.0b013e3182a0da47.
[37]	TAN L X, DU X K, TANG R M, et al. Effect of spinal-pelvic sagittal balance on the clinical outcomes after lumbar fusion surgery[J]. BMC Surgery, 2023, 23(1):334. doi:10.1186/s12893-023-02240-y.
[38]	LIANG C, SUN J, CUI X, et al. Spinal sagittal imbalance in patients with lumbar disc herniation:its spinopelvic characteristics,strength changes of the spinal musculature and natural history after lumbar discectomy[J]. BMC Musculoskelet Disord, 2016,17:305. doi:10.1186/s12891-016-1164-y.
[39]	LIOW M, GOH G S, CHUA J L, et al. Sagittally balanced degenerative spondylolisthesis patients with increased sacral slope and greater lumbar lordosis experience less back pain after short-segment lumbar fusion surgery[J]. Clin Spine Surg, 2020, 33(5):E231-E235. doi:10.1097/BSD.0000000000000923.
[40]	WANIVENHAUS F, BAUER D E, LAUX C, et al. Risk factors for L5 pedicle fractures after single-level posterior spinal fusion[J]. Spine J, 2022, 22(6):927-933. doi:10.1016/j.spinee.2022.01.010.
[41]	YOON S G, LEE H C, LEE S M. Pelvic incidence-lumbar lordosis mismatch is predisposed to adjacent segment degeneration after single-level anterior lumbar interbody fusion:a retrospective case-control study[J]. Neurospine, 2023, 20(1):301-307. doi:10.14245/ns.2244934.467.
[42]	ROTHENFLUH D A, MUELLER D A, ROTHENFLUH E, et al. Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion[J]. Eur Spine J, 2015, 24(6):1251-1258. doi:10.1007/s00586-014-3454-0.
[43]	KAWAI T, SHIMIZU T, GOTO K, et al. The impact of spinopelvic parameters on hip degeneration after spinal fusion[J]. Spine(Phila Pa 1976), 2022, 47(15):1093-1102. doi:10.1097/BRS.0000000000004340.
[44]	BAE J, THEOLOGIS A A, STROM R, et al. Comparative analysis of 3 surgical strategies for adult spinal deformity with mild to moderate sagittal imbalance[J]. J Neurosurg Spine, 2018, 28(1):40-49. doi:10.3171/2017.5.SPINE161370.
[45]	BAO H, ZHU F, LIU Z, et al. Coronal curvature and spinal imbalance in degenerative lumbar scoliosis:disc degeneration is associated[J]. Spine(Phila Pa 1976), 2014, 39(24):E1441-E1447. doi:10.1097/BRS.0000000000000603.

脊柱-骨盆矢状位参数与腰椎融合术预后相关性的研究进展

Research progress on the correlation between sagittal spinopelvic parameters and the prognosis of lumbar fusion surgery

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

参考文献 45

相关文章 15

编辑推荐

Metrics

本文评价

[1]	张阳, 段颖, 崔明霞, 树玲博. 内路小梁切开术对原发性开角型青光眼患者眼压及视力的影响[J]. 天津医药, 2025, 53(1): 85-87.
[2]	朱文智, 邱倩, 谭宏宇. 术前焦虑对肝癌患者麻醉苏醒与术后恢复的影响[J]. 天津医药, 2024, 52(7): 762-765.
[3]	王敏, 王龙胜, 陈磊. 骨质疏松症患者腰椎骨折预测模型的构建[J]. 天津医药, 2024, 52(7): 766-769.
[4]	杜晨阳, 罗文, 王勇, 段鑫, 柯文杰, 石念, 武英翔. 腹腔镜下完全腹膜外Sublay治疗腰疝的疗效分析[J]. 天津医药, 2024, 52(5): 514-517.
[5]	李朝园, 赵富浩, 陈莎, 吕睿倩, 武子霞. 不同血管通路对老年维持性血液透析患者的效果比较[J]. 天津医药, 2024, 52(12): 1266-1269.
[6]	杨凯, 侯丁聪, 段少先, 毕怡, 谢炎, 张骊, 蒋文涛. PNI、LMR、MELD对肝移植术后早期肺部感染的预测价值[J]. 天津医药, 2024, 52(10): 1041-1045.
[7]	张晓, 商亮, 阮智. 腰椎后路椎间融合术对椎旁肌损伤的影响研究[J]. 天津医药, 2023, 51(4): 392-394.
[8]	邵艳梅, 宋洁, 杨梦思, 黄孝慈, 汤昕宇, 胡宪文. 允许性高碳酸血症对老年胸腔镜食管癌根治术患者术后谵妄的影响[J]. 天津医药, 2023, 51(3): 282-285.
[9]	赵雪楠, 郭旭峰, 丁成智, 陈东东, 韦丽瑞, 李晨, 秦贵军, 王娇. 体质量指数对食管鳞癌患者术后并发症和长期预后的影响[J]. 天津医药, 2023, 51(10): 1131-1135.
[10]	何士凤, 朱泽飞, 张婉月, 杨贯宇, 郑红雨, 孙振涛△. 基于脑电小波指数的人工智能给药系统的临床应用[J]. 天津医药, 2022, 50(6): 648-652.
[11]	张玉, 孙炜, 孙维超, 姜骆永, 阳世伟, △. 入院红细胞体积分布宽度与老年髋部骨折术后肺部感染的关系及其预测价值[J]. 天津医药, 2022, 50(6): 608-612.
[12]	岳宗进, 刘汝银△, 于露, 王新立, 冯仲锴, 王西彬. 葛根总皂苷调控NAMPT-Sirt1轴诱导BMSCs向髓核样细胞分化#br#[J]. 天津医药, 2021, 49(9): 897-903.
[13]	张蕾, 赵红, 潘叶△. 改良扇形额肌瓣悬吊术矫正重度上睑下垂的临床研究[J]. 天津医药, 2021, 49(9): 996-999.
[14]	金菊英, 刘丹, 闵苏. 术中目标导向的晶体液或胶体液输注对胃肠道术后并发症的影响[J]. 天津医药, 2021, 49(8): 852-856.
[15]	刘越, 姜洪丰, 黄洪超, 黎宁, 徐宝山. 有关退变性腰椎滑脱治疗的争议问题[J]. 天津医药, 2021, 49(8): 883-886.