老年腰椎管狭窄症病人退行性腰椎侧弯的影响因素分析

doi:10.3969/j.issn.1003-9198.2023.09.012

摘要/Abstract

摘要： 目的探讨老年腰椎管狭窄症(LSCS)病人退行性腰椎侧弯(DLS)的影响因素,为临床DLS的防治提供参考。方法回顾性选择2017年1月至2022年1月我院收治的296例老年LSCS病人,根据是否合并DLS分为DLS组(74例)和非DLS组(222例)。收集病人人口学、临床以及影像学资料,采用多因素Logistic回归分析影响老年LSCS病人发生DLS的危险因素。结果 DLS组年龄≥70岁、女性、体质量指数≥25、骨质疏松、肌少症、Pfirrmann分级4～5级比例高于非DLS组(P＜0.05),侧凸Cobb角、L₃倾斜角、骨盆入射角(PI)、骨盆倾斜角(PT)、矢状位平衡(SVA)大于非DLS组(P＜0.05),腰椎前凸(LL)、骶骨倾斜角(SS)小于非DLS组(P＜0.05)。多因素Logistic回归分析显示,年龄≥70岁、骨质疏松、肌少症、Pfirrmann分级4～5级、PI、SVA是老年LSCS病人发生DLS的危险因素,LL是保护因素(P＜0.05)。结论年龄、骨质疏松、肌少症、Pfirrmann分级、LL、PI、SVA与老年LSCS病人DLS的发生有关,临床应加强高危病人的干预和治疗,预防和减少DLS的发生。

关键词: 腰椎管狭窄, 腰椎侧弯, 骨质疏松, 肌少症, 危险因素

Abstract: Objective To investigate the influencing factors of degenerative lumbar scoliosis (DLS) in elderly patients with lumbar spinal stenosis (LSCS), and to provide reference for clinical prevention and treatment of DLS. Methods A total of 296 elderly patients with LSCS admitted to our hospital from January 2017 to January 2022 were retrospectively selected and divided into DLS group (74 cases) and non-DLS group (222 cases). Demographic, clinical and imaging data of the patients were collected, and multivariate Logistic regression was used to analyze the risk factors for DLS in elderly LSCS patients. Results The proportions of age ≥70 years old, female, body mass index ≥25, osteoporosis, sarcopenia in DLS group were higher than those in non-DLS group (P<0.05), Pfirrmann grade 4-5, scoliosis Cobb angle, L3 tilt angle, pelvic incidence(PI), pelvic tilt(PT), sagittal vertical axis(SVA) in DLS group were larger than those in non-DLS group, and lumbar lordosis(LL)and sacral slope(SS)in DLS group were less than those in non-DLS group (P<0.05). Logistic regression showed that age ≥70 years, osteoporosis, sarcopenia, Pfirrmann grade 4-5, PI and SVA were risk factors for DLS in elderly LSCS patients (P<0.05), and LL was a protective factor (P<0.05). Conclusions Age, osteoporosis, sarcopenia, Pfirrmann grade 4-5, LL, PI and SVA are related to the occurrence of DLS in elderly LSCS patients. Clinical intervention and treatment for high-risk patients should be strengthened to prevent and reduce the occurrence of DLS.

Key words: lumbar spinal canal stenosis, degenerative lumbar scoliosis, osteoporosis, sarcopenia, risk factor

中图分类号:

R 682.3

赵小魁, 邵楠, 张胜国, 杨万石. 老年腰椎管狭窄症病人退行性腰椎侧弯的影响因素分析[J]. 实用老年医学, 2023, 37(9): 911-914.

ZHAO Xiao-kui, SHAO Nan, ZHANG Sheng-guo, YANG Wan-shi. Influencing factors of degenerative lumbar scoliosis in elderly patients with lumbar spinal canal stenosis[J]. Practical Geriatrics, 2023, 37(9): 911-914.

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