腰骶部椎体滑脱的生物力学认识和分型.pdfVIP

1134 Chinese Journal of Reparative and Reconstructive Surgery, September 2013, Vol. 27, No.9 · · • 综 述• 腰骶部椎体滑脱的生物力学认识和分型 龚全 孔清泉 【摘  要】    目的 综述腰骶部椎体滑脱发病和发展机制相关方面的研究进展，探讨腰骶部椎体滑脱国际脊柱畸 形学会（SDSG ）分型方法的实用价值。 方法 查阅近年与腰骶部椎体滑脱发生和发展机制相关的国内外文献，结合 SDSG 分型方法综合分析。 结果 骨盆指数（pelvic incidence ，PI ）是影响脊柱矢状面平衡和导致腰骶部椎体滑脱产生 的关键因素。滑脱Meyerding 分度、PI 和脊柱- 骨盆的平衡情况是影响滑脱是否进展的主要因素，也是影响滑脱治疗方 式和预后效果的关键因素。腰骶部椎体滑脱SDSG 分型方法与Wiltse 、Marchetti-Bartolozzi 和Mac-Thiong-Labelle 等分 型方法相比，组内个体同质性更好，可信度更佳，能更好指导临床治疗和判断预后。 结论 在临床实践中，宜将SDSG 分型方法作为腰骶部椎体滑脱的分型标准。 【关键词】 腰骶部椎体滑脱 矢状面平衡 分型标准 骨盆指数 骨盆倾斜角 BIOMECHANICAL ANALYSIS AND CLASSIFICATION OF LUMBOSACRAL SPONDYLOLISTHESIS/GONG Quan, KONG Qingquan. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China. Corresponding author: KONG Qingquan, E-mail: kongspine@126.com 【Abstract 】 Objective To review the research progress of the risk factors for sli p progression and the pathogenesis of lumbosacral spondylolisthesis, and to discuss the value of Spinal Deformity Study Group (SDSG) classification system for lumbosacral spondylolisthesis. Methods Recent articles about the risk factors for sli p progression and the pathogenesis of lumbosacral spondylolisthesis were reviewed and comprehensively analyzed with SDSG classification system of lumbosacral spondylolisthesis. Results Pelvic incidence (PI) is the key pathogenic factor of lumbosacral spondylolisthesis. The Meyerding grade of sli p, PI, sacro-pelvic balance, and spino-pelvic balance not only are the fundamental risk factors of sli p progression, but also are the key factors to determine how to treat and influence the prognosis. Therefore, compared with Wiltse, Marchetti- Bartolozzi, and Mac-Thiong-La