PDF(Pubmed)
Abstract：
BACKGROUND: To evaluate the sex-based differences in clinical and radiological presentation of patients with degenerative lumbar scoliosis (DLS) and to explore whether the difference is helpful in investigating the etiology and progression of DLS.
METHODS: A retrospective review of 199 patients (41 males, 158 females) with DLS was included. Patient demographics including age, gender, bone mineral density were collected. Back and leg pain was assessed by visual analog scale, and general physical condition was assessed by Oswestry Disability Index. Cobb\'s angle was measured, and direction of scoliosis, position of the superior, inferior and apex vertebrae, number of vertebrae included in the scoliosis, rotation of apex vertebrae (Nash-Mo index), translation of apex vertebrae were recorded. Sagittal longitudinal axis, thoracolumbar kyphosis, lumbar lordosis (LL), pelvic incidence angle (PI), sacral slope, apex of lumbar lordosis and coronal balance distance were measured by whole spine lateral radiographs, and type of coronal imbalance was evaluated in all patients. Fat infiltration rate (FIR) of the paraspinal muscles at the vertebral apex was measured by MRI.
RESULTS: Compared to female patients, male patients showed more back and leg pain on clinical presentation and smaller Cobb angle, less parietal rotation, larger LL, smaller PI-LL and lower paravertebral muscle FIR on radiologic features.
CONCLUSIONS: Gender differences do exist in DLS patients with regard to clinical and radiological presentation, low back pain was more pronounced in male patients, and scoliosis was more severe in female patients based on this cross-sectional study.
METHODS: A retrospective review of 199 patients (41 males, 158 females) with DLS was included. Patient demographics including age, gender, bone mineral density were collected. Back and leg pain was assessed by visual analog scale, and general physical condition was assessed by Oswestry Disability Index. Cobb\'s angle was measured, and direction of scoliosis, position of the superior, inferior and apex vertebrae, number of vertebrae included in the scoliosis, rotation of apex vertebrae (Nash-Mo index), translation of apex vertebrae were recorded. Sagittal longitudinal axis, thoracolumbar kyphosis, lumbar lordosis (LL), pelvic incidence angle (PI), sacral slope, apex of lumbar lordosis and coronal balance distance were measured by whole spine lateral radiographs, and type of coronal imbalance was evaluated in all patients. Fat infiltration rate (FIR) of the paraspinal muscles at the vertebral apex was measured by MRI.
RESULTS: Compared to female patients, male patients showed more back and leg pain on clinical presentation and smaller Cobb angle, less parietal rotation, larger LL, smaller PI-LL and lower paravertebral muscle FIR on radiologic features.
CONCLUSIONS: Gender differences do exist in DLS patients with regard to clinical and radiological presentation, low back pain was more pronounced in male patients, and scoliosis was more severe in female patients based on this cross-sectional study.
摘要：
背景：评估退行性腰椎侧凸（DLS）患者的临床和影像学表现的性别差异，并探讨差异是否有助于研究DLS的病因和进展。
方法：对199例患者（41例男性，158名女性）包括DLS。患者人口统计学特征，包括年龄，性别,收集骨密度。背部和腿部疼痛通过视觉模拟量表进行评估，通过Oswestry残疾指数评估一般身体状况。测量了Cobb的角度,和脊柱侧弯的方向，上级的位置,下和顶点椎骨，脊柱侧凸中包括的椎骨数量，根尖椎骨旋转（纳什-钼指数），记录根尖椎骨的平移。矢状纵轴,胸腰椎后凸畸形,腰椎前凸(LL),骨盆入射角(PI),骶骨斜坡,通过全脊柱侧位X线片测量腰椎前凸顶点和冠状平衡距离，并对所有患者的冠状失衡类型进行评估。通过MRI测量椎尖旁肌的脂肪浸润率（FIR）。
结果：与女性患者相比，男性患者在临床表现上表现出更多的背部和腿部疼痛和较小的Cobb角，顶叶旋转较少，较大的LL，在放射学特征上，PI-LL和下椎旁肌FIR较小。
结论：DLS患者在临床和放射学表现方面确实存在性别差异，腰背痛在男性患者中更为明显，根据这项横断面研究，女性患者的脊柱侧弯更为严重。
方法：对199例患者（41例男性，158名女性）包括DLS。患者人口统计学特征，包括年龄，性别,收集骨密度。背部和腿部疼痛通过视觉模拟量表进行评估，通过Oswestry残疾指数评估一般身体状况。测量了Cobb的角度,和脊柱侧弯的方向，上级的位置,下和顶点椎骨，脊柱侧凸中包括的椎骨数量，根尖椎骨旋转（纳什-钼指数），记录根尖椎骨的平移。矢状纵轴,胸腰椎后凸畸形,腰椎前凸(LL),骨盆入射角(PI),骶骨斜坡,通过全脊柱侧位X线片测量腰椎前凸顶点和冠状平衡距离，并对所有患者的冠状失衡类型进行评估。通过MRI测量椎尖旁肌的脂肪浸润率（FIR）。
结果：与女性患者相比，男性患者在临床表现上表现出更多的背部和腿部疼痛和较小的Cobb角，顶叶旋转较少，较大的LL，在放射学特征上，PI-LL和下椎旁肌FIR较小。
结论：DLS患者在临床和放射学表现方面确实存在性别差异，腰背痛在男性患者中更为明显，根据这项横断面研究，女性患者的脊柱侧弯更为严重。
