Effect Of Sagittal Balance Of Lumbar Pelvis On The Pathogenesis Of Lumbar Disc Herniation And Its Clinical Significance

Objective:To study the characteristics of sagittal balance parameters of lumbar pelvis in patients with lumbar disc herniation,and to explore the relationship between lumbar disc herniation and lumbar pelvic balance based on the theory of "balance of tendons and bones".To analyze the sagittal balance parameters of lumbar spine and pelvis as an index of the coordination of lumbar spine and pelvis,and to provide theoretical support for the prevention,treatment and rehabilitation of lumbar disc herniation.Methods:1.From August 2017 to February 2019 during outpatient and hospitalized cases selected to meet the requirements of the 78 cases,of which the disease in patients with degenerative lumbar intervertebral disc protrusion 47 cases,no normal lumbar disease,31 cases in the lumbar spine,pelvis,and bilateral femoral head lateral X ray film on pelvic incidence Angle measurement PI(pelvic incidence),sacral slope Angle SS(sacral slope),pelvic tilt Angle PT(pelvic tilt),lumbar lordosis Angle of LL(lumbar lordosis).LA(Lumbar Angle),L1 tilting Angle L1T(L1 tilting Angle),etc.The characteristics of sagittal balance parameters of lumbar pelvis were compared between patients with lumbar disc herniation and those without lumbar spine disease.2.Reference data recorded in the related literature at home and abroad research,for the first part of lumbar sagittal balance parameter values with pelvic sagittal balance parameter values for relevant statistical analysis,the disease in patients with degenerative lumbar intervertebral disc protrusion of lumbar spinal sagittal parameters and pelvic sagittal parameters were analyzed,to explore the disease in patients with degenerative lumbar intervertebral disc protrusion of the lumbar spine and pelvis between the existence of certain coordination.Results:1.In total,the sagittal parameters of the lumbar vertebra and pelvis of 78 patients with tele-disc herniation and normal patients were measured,with an average age of 42 yearsold,the minimum age of 17 years old and the maximum age of 63 years old,among which 33 were male,accounting for 42.3%,45 were female,accounting for 57.7%.The value of sagittal position parameters of lumbar vertebra and pelvis in the lumbar protrusion group and the normal group was analyzed and compared by independent t test of the two samples,and the difference was statistically significant(P<0.05).Compared with the normal group: Waist of SS,LL and LA tu disease group were significantly reduced,PI,PT and L1 T were significantly increased,the parameters of pelvic incidence Angle PI(pelvic incidence),sacral slope Angle SS(sacral slope),pelvic tilt Angle PT(pelvic tilt),lumbar lordosis Angle of LL(lumbar lordosis),lumbar spine Angle of LA(lumbar Angle),The differences of L1 tilting Angle L1 T were statistically significant(P<0.05).2.Pearson correlation coefficient analysis between lumbar sagittal parameters and pelvic sagittal parameters in lumbar process group: there was a positive correlation between pelvic incidence PI and lumbar angle LA(r = 0.780;P < 0.05);sacral slope SS(sacral slope)and lumbar lordosis LL(r = 0.878;P < 0.05);There was a positive correlation between SS(sacral slope)and L1 tilting angle(L1 tilting angle)(r = 0.501;P< 0.05);there was a positive correlation between pelvic tilt and lumbar angle LA(r =0.544;P < 0.05).Conclusion:1.Patients with lumbar disc herniation have higher PI and PT than normal patients without lumbar spine disease,and lower SS than normal patients without lumbar spine disease.High PI,PT and low SS may be the risk factors of lumbar disc herniation.Patients with lumbar disc herniation have lower LL and LA than normal patients without lumbar disc disease,and higher L1 T than normal patients without lumbar disc disease.Low LL,LA and high L1 T may also be risk factors for the occurrence of lumbar disc herniation.2.There is a certain correlation between the occurrence and development of PI,PT,SS and lumbar disc herniation.The larger the PI and PT are,the smaller the SS is,and the higher the risk of degenerative changes of lumbar disc is.LL,LA and L1 T are also correlated with the occurrence and development of lumbar disc herniation.The smaller LL and LA are,the larger L1 T is,and the higher the risk of degenerative changes of lumbar intervertebral disc is.3.In patients with lumbar disc herniation,lumbar lordosis Angle LL and lumbar AngleLA were significantly reduced compared with those without normal lumbar spine diseases,which were characterized by low lordosis radian of lumbar spine,low inclination of lumbar spine 3 and forward tilt of spine.4.PI and LA in patients with lumbar disc prolapse,SS and LL,L1 T,PT and LA there is significant correlation between these parameters,in a normal physiological function between human lumbar spine and pelvis,anatomical structure,physiological position,has certain relevance,matching and coordination,lumbar sagittal balance parameters and pelvic sagittal balance has certain correlation between parameters,in the midst of lumbar degenerative disease,disease clinical lumbar disc prolapse of lumbar spine and pelvis incoordination between the pelvis through position adjustment can dynamically adjust the lumbar sagittal balance.