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1972年,Jean Dubousset (CD器械发明者)提出了“经济圆锥”(cone of economy)理论,认为人在站立时“稳定”的范围是从足到头形成一个倒立的圆锥形区域。在这个范围内,人体消耗最小能量保持平衡。在前后或侧方偏离了这个圆锥区,需要消耗更多能量保持站立位(Within the center of the cone, the individual may remain in an ergonomically favorable erect position. However, larger deviations in the anterior-posterior or lateral plane will require greater energy use to maintain a standing position.)。后来,全脊柱平衡的各个矢状位参数,可以看作这个理论的细化。
1. 重力线(Gravity Line,GL)
GL主要用与关节外科下肢力的研究,在脊柱平衡中也有较多研究。但人体站立位全长照片并非易事,脊柱外科更倾向较短的脊柱全长位片。
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2. 颈7铅锤线和SVA (C7 plumb line, C7PL; Sagittal vertical axis, SVA)
C7PL是脊柱矢状位平衡的生命线(与CSVL是冠状位平衡的生命线一样)。SRS-Schwab因为有SVA的标准,使得其在ASD矫形中的作用远高于没有涉及SVA的Roussouly分型和GAP评分。
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3. 胸1椎骨盆角(T1 pelvic angle, TPA)
TPA被很多人认为是反映矢状位平衡的最好参数,小于26°。
4. 髋轴肺门水平距(Horizontal distance between hip axis and hilus pulmonis, HDHH)
301医院发表的AS矫正参数,采用HP可以设计AS截骨。
5. T4-L1-髋轴(T4-L1-Hip Axis)
最近报道的矢状位参数,预测腰前凸有意义。
声明:本文转载于<脊柱外科医生张正丰>,版权归原作者所有,仅用于学习交流,未经授权禁止转载!