A Study On The Spino-pelvic Sagittal Parameters With Lumbar Disc Herniation

Objective:To explore the difference of Chinese adult patients with lumbar disc herniation and normal people spino pelvic parameters;and on the basis of gender,comparative study of male and female patients with lumbar disc herniation spino pelvic parameters and the difference of morbidity.Method:A retrospective analysis the patients with LDH from January 2014 to March 2016 in spine surgery of Xijing Hospital of The Fourth Military Medical University.The patients with LDH must have preoperative total spinal lateral X-ray of standing,with strict inclusion and exclusion criteria,a total of 222 cases were collected.Using the method described by Horton take the standard full spine lateral X-ray film;Appling graphic analysis software Surgimap to measure parameters,measurement datas including: pelvic incidence(PI),pelvic tilt(PT),sacral inclination angle(SS),thoracic kyphosis(TK),lumbar lordosis(LL)sagittal vertical axis(SVA).Appling statistical analysis software SPSS19.0 to calculate the relevant parameters.In part one,two sample z test was used for statistical analysis comparing the parameters of LDH patients and normal peoples' s;in part two,according to gender,LDH patients were divided into 2 groups,using two independent sample t test,Pearson chi square test,U test of two sample rate statistics to comparise spino-pelvic sagittal parameters,the incidence of involved segments of different ages,the incidence of the existence of different age group in different gender.Result:222 cases were collected with 125 males and 97 females,aged 20 to 80 years old,the average age of 50.97 years old;there were 285 lesions of intervertebral disc,including L1/2 2 cases,L2/3 8 cases,L3/4 26 cases,L4/5 153 cases,L5/S1 94 cases;171 cases involving a single segment,51 cases involving tow or more segments.In part one,the comparison of LDH patients and normal young people in China,there was no significant difference in TK,PI,but with statistically significant differences in PT,SS,LL,SVA(P<0.05);comparison of LDH patients and normal quinquagenarians,there was no significant difference of PI,but with statistical significance in PT,SS,LL TK,SVA(P<0.05);According to the gender differences,the PI of LDH patients were compared with those of the normal PI,there was no significant difference of PI.In part two,the patients were divided into two groups on the basis of gender for statistical comparison,male patients with PI 43.82 plus or minus 8.66 degrees,female PI 47.75 plus or minus 8.50 degrees,P=0.001(P<0.05),the difference was statistically significant.Age,PT,SS,LL,TK,SVA had no significant difference between the two groups;Which different gender patients involved segments showed no significant difference(P=0.480);The composition of different gender patients with different age groups have statistically significant difference(P<0.05);In patients with LDH,male component ratio is significantly greater than women in 20-40 years old group(P < 0.05).Conclusion:The PI of adult patients with LDH(20-80 years old)in our country was 45.5°±8.8°,and there was no significant difference compared with the normal PI.PT,SVA increased,SS,LL,TK decreased.PI in men and women patients with LDH(male: 43.82°±8.66°,female 47.54±8.50°)was a statistical difference,the male is less than the female.The gender of LDH patients was no significant difference in the incidence of segment.There were significant differences in the constituent ratio of different age groups of LDH patients,and the proportion of male 20-40 years old was significantly higher than that of female.PI was smaller in men with LDH,it is maybe a reason why LDH in men more than women and men more younger morbidity.