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脊椎骨对齐的动态补偿及其与腰椎脊柱狭窄症患者症状严重程度的关系

David Koch¹, Nicola Büttiker², Corina Nüesch¹

¹Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167b, 4123 Allschwil, Switzerland.

The spine journal : official journal of the North American Spine Society

|January 15, 2026

概括

脊椎骨盆对齐的动态补偿,特别是骨盆运动,与症状性腰椎脊柱狭窄症 (sLSS) 患者的症状严重程度有关. 在步行过程中更大的骨盆逆转与增加的残疾相关,突出了骨盆.

科学领域:

脊柱生物力学和临床结果
在脊椎疾病中进行放射和运动分析.

背景情况:

症状的腰椎脊柱狭窄 (sLSS) 疼痛与姿势相关,但静态放射学错过了动态补偿机制.
一种新的方法量化了从姿势到步态的动态脊骨骨对齐变化.

研究的目的:

调查静态脊平衡与步行过程中的动态补偿之间的关联.
评估脊骨皮层对齐,动态补偿和sLSS症状严重程度之间的关系.
确定细分不稳定发生率及其对对齐-症状关系的影响.

主要方法:

在119名接受手术的sLSS患者的横截面观察研究.
EOS放射和MRI用于静态对齐和狭窄分级.
动作捕捉与偏移校正用于动态脊骨平衡 (T9倾斜,骨盆倾斜,十字斜率,脊柱倾斜,脊骨角).
动态补偿计算为步态和姿态角度之间的差异.

主要成果:

在T9倾斜,骨盆倾斜和脊柱倾斜的静态和动态参数之间发现了微弱至中度的相关性.
静态/步态对齐与奥斯威斯特里残疾指数 (ODI) 之间没有相关性.
骨盆倾斜的动态补偿 (正值) 和脊角 (负值) 显示出与ODI的显著关系较弱.

结论:

动态的脊皮补偿受到sLSS患者的姿势对齐的影响.
盆腔动态补偿,而不是静态对齐,与症状严重程度 (残疾) 相相关.
在步行与姿势之间增加的骨盆逆转与更大的残疾有关,强调骨盆在sLSS中的临床重要性.

关键词:

腰椎脊柱狭窄症腰椎脊柱狭窄症动态补偿是动态的补偿.步态生物力学生物力学运动捕捉分析分析.补偿纠正的补偿纠正患者报告的结果.骨盆倾斜的情况脊皮皮层对齐脊皮层对齐

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