腰骶部椎體滑脫的生物力學認識和分型_《中國修復重建外科雜志》

作者：

龔全 , 孔清泉

四川大學華西醫院骨科（成都，610041）;

關鍵詞：

腰骶部椎體滑脫矢狀面平衡分型標準骨盆指數骨盆傾斜角

DOI：

10.7507/1002-1892.20130247

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目的綜述腰骶部椎體滑脫發病和發展機制相關方面的研究進展，探討腰骶部椎體滑脫國際脊柱畸形學會（SDSG）分型方法的實用價值。方法查閱近年與腰骶部椎體滑脫發生和發展機制相關的國內外文獻，結合SDSG分型方法綜合分析。結果骨盆指數（pelvic incidence，PI）是影響脊柱矢狀面平衡和導致腰骶部椎體滑脫產生的關鍵因素。滑脫Meyerding分度、PI和脊柱-骨盆的平衡情況是影響滑脫是否進展的主要因素，也是影響滑脫治療方式和預后效果的關鍵因素。腰骶部椎體滑脫SDSG分型方法與Wiltse、Marchetti-Bartolozzi和Mac-Thiong-Labelle等分型方法相比，組內個體同質性更好，可信度更佳，能更好指導臨床治療和判斷預后。結論在臨床實踐中，宜將SDSG分型方法作為腰骶部椎體滑脫的分型標準。

引用本文： 龔全,孔清泉. 腰骶部椎體滑脫的生物力學認識和分型. 中國修復重建外科雜志, 2013, 27(9): 1134-1137. doi: 10.7507/1002-1892.20130247 復制

1.	Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res, 1976, (117): 23-29.
2.	Marchetti PG, Bartolozzi P. Classification of spondylolisthesis as a guideline for treatment//Bridwell K, DeWald R. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven, 1997: 1211-1254.
3.	Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine (Phila Pa 1976), 2005, 30(Suppl 6): S4-11.
4.	McCarty ME, Mehlman CT, Tamai J, et al. Spondylolisthesis: intraobserver and interobserver reliability with regard to the measurement of slip percentage. J Pediatr Orthop, 2009, 29(7): 755-759.
5.	Lamartina C, Zavatsky JM, Petruzzi M, et al. Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J, 2009, 18 Suppl 1: 133-142.
6.	Mac-Thiong JM, Wang Z, de Guise JA, et al. Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976), 2008, 33(21): 2316-2325.
7.	Labelle H, Roussouly P, Berthonnaud E, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976), 2004, 29(18): 2049-2054.
8.	Debarge R, Demey G, Roussouly P. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis. Eur Spine J, 2011, 20(Suppl 5): 619-625.
9.	Li W, Sun Z, Guo Z, et al. Analysis of spino-pelvic sagittal alignment in patients with thoracic and thoracolumbar angular kyphosis. Spine (Phila Pa 1976), 2013. [Epub ahead of print].
10.	Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976), 1997, 22(20): 2452-2457.
11.	Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J, 2011, 20 Suppl 5: 609-618.
12.	Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J, 2011, 20 Suppl 5: 641-646.
13.	Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976), 2009, 34(17): 1828-1833.
14.	Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech, 2005, 18(1): 40-47.
15.	Boulay C, Tardieu C, Hecquet J, et al. Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J, 2006, 15(4): 415-422.
16.	Barrey C, Jund J, Perrin G, et al. Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery, 2007, 61(5): 981-986.
17.	Hresko MT, Labelle H, Roussouly P, et al. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine (Phila Pa 1976), 2007, 32(20): 2208-2213.
18.	Mac-Thiong JM, Labelle H. A proposal for a surgical classification of pediatric lumbosacral spondylolisthesis based on current literature. Eur Spine J, 2006, 15(10): 1425-1435.
19.	Mac-Thiong JM, Labelle H, Parent S, et al. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis, 2008, 3: 19.
20.	Roussouly P, Gollogly S, Berthonnaud E, et al. Sagittal alignment of the spine and pelvis in the presence of L5-S1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976), 2006, 31(21): 2484-2490.
21.	Mac-Thiong JM, Duong L, Parent S, et al. Reliability of the Spinal Deformity Study Group classification of lumbosacral spondylolisthesis. Spine (Phila Pa 1976), 2012, 37(2): E95-102.
22.	Harroud A, Labelle H, Joncas J, et al. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J, 2013, 22(4): 849-856.

1. Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res, 1976, (117): 23-29.
2. Marchetti PG, Bartolozzi P. Classification of spondylolisthesis as a guideline for treatment//Bridwell K, DeWald R. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven, 1997: 1211-1254.
3. Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine (Phila Pa 1976), 2005, 30(Suppl 6): S4-11.
4. McCarty ME, Mehlman CT, Tamai J, et al. Spondylolisthesis: intraobserver and interobserver reliability with regard to the measurement of slip percentage. J Pediatr Orthop, 2009, 29(7): 755-759.
5. Lamartina C, Zavatsky JM, Petruzzi M, et al. Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J, 2009, 18 Suppl 1: 133-142.
6. Mac-Thiong JM, Wang Z, de Guise JA, et al. Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976), 2008, 33(21): 2316-2325.
7. Labelle H, Roussouly P, Berthonnaud E, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976), 2004, 29(18): 2049-2054.
8. Debarge R, Demey G, Roussouly P. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis. Eur Spine J, 2011, 20(Suppl 5): 619-625.
9. Li W, Sun Z, Guo Z, et al. Analysis of spino-pelvic sagittal alignment in patients with thoracic and thoracolumbar angular kyphosis. Spine (Phila Pa 1976), 2013. [Epub ahead of print].
10. Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976), 1997, 22(20): 2452-2457.
11. Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J, 2011, 20 Suppl 5: 609-618.
12. Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J, 2011, 20 Suppl 5: 641-646.
13. Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976), 2009, 34(17): 1828-1833.
14. Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech, 2005, 18(1): 40-47.
15. Boulay C, Tardieu C, Hecquet J, et al. Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J, 2006, 15(4): 415-422.
16. Barrey C, Jund J, Perrin G, et al. Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery, 2007, 61(5): 981-986.
17. Hresko MT, Labelle H, Roussouly P, et al. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine (Phila Pa 1976), 2007, 32(20): 2208-2213.
18. Mac-Thiong JM, Labelle H. A proposal for a surgical classification of pediatric lumbosacral spondylolisthesis based on current literature. Eur Spine J, 2006, 15(10): 1425-1435.
19. Mac-Thiong JM, Labelle H, Parent S, et al. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis, 2008, 3: 19.
20. Roussouly P, Gollogly S, Berthonnaud E, et al. Sagittal alignment of the spine and pelvis in the presence of L5-S1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976), 2006, 31(21): 2484-2490.
21. Mac-Thiong JM, Duong L, Parent S, et al. Reliability of the Spinal Deformity Study Group classification of lumbosacral spondylolisthesis. Spine (Phila Pa 1976), 2012, 37(2): E95-102.
22. Harroud A, Labelle H, Joncas J, et al. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J, 2013, 22(4): 849-856.

《中國修復重建外科雜志》

腰骶部椎體滑脫的生物力學認識和分型

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《中國修復重建外科雜志》

腰骶部椎體滑脫的生物力學認識和分型

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