腰椎黄韧带肥厚与脊柱-骨盆矢状面平衡相关性的影像学评价.

BACKGROUND: The pathogenesis of hypertrophy of lumbar ligamentum flavum is complex, and whether it is related to the sagittal spinopelvic balance remains unclear. OBJECTIVE: To investigate the relationship between hypertrophy of lumbar ligamentum flavum and sagittal spinopelvic balance parameters. METHODS: A retrospective analysis of the clinical data of 38 patients with lumbar degenerative diseases admitted to hospital from January 2015 to December 2017 was conducted. The sagittal spinopelvic balance parameters, including thoracic kyphosis, lumbar lordosis, sacral slope, pelvic incidence, pelvic tilt, sagittal vertical axis, were measured on the full-length radiographs in standing position. The thickness of lumbar ligamentum at L1-2, L2-3, L3-4, L4-5, L5-S1 was measured on the axial T2-weighed MR images at the facet joint level. In order to analyze the relationship between hypertrophy of lumbar ligamentum flavum and sagittal spinopelvic balance parameters, patients were divided into normal group (thickness of ligamentum ≤ 3 mm) and hypertrophy group (thickness of ligamentum > 3 mm) RESULTS AND CONCLUSION: (1) There was no significant difference in the sex and body mass index between two groups at each segment (P > 0.05), but age showed significant difference (P < 0.05). (2) There was significant difference in the thoracic kyphosis at L1-2 between groups (P < 0.05). There were significant differences in the thoracic kyphosis and pelvic tilt at L2-3 between groups (P < 0.05). There was no significant difference in the thoracic kyphosis at L3-4 between groups (P=0.054). There was significant difference in the lumbar lordosis at L4-5 (P < 0.05). The parameters at L5-S1 showed no significant difference between groups. (3) There was a negative correlation between L5-S1 thickness and sagittal vertical axis (r=-0.33, P < 0.05). (4) To conclude, hypertrophy of ligamentum flavum is closely related to the sagittal spinopelvic balance parameters. [ABSTRACT FROM AUTHOR]