The effect of age on sagittal plane profile of the lumbar spine according to standing, supine, and various sitting positions
Tóm tắt
The sagittal alignment of the spine changes depending on body posture and degenerative changes. This study aimed to observe changes in sagittal alignment of the lumbar spine with different positions (standing, supine, and various sitting postures) and to verify the effect of aging on lumbar sagittal alignment. Whole-spine lateral radiographs were obtained for young volunteers (25.4 ± 2.3 years) and elderly volunteers (66.7 ± 1.7 years). Radiographs were obtained in standing, supine, and sitting (30°, 60°, and 90°) positions respectively. We compared the radiological changes in the lordotic and segmental angles in different body positions and at different ages. Upper and lower lumbar lordosis were defined according to differences in anatomical sagittal mobility and kinematic behavior. Lumbar lordosis was greater in a standing position (52.79° and 53.90° in young and old groups, respectively) and tended to decrease as position changed from supine to sitting. Compared with the younger group, the older group showed significantly more lumbar lordosis in supine and 60° and 90° sitting positions (P = 0.043, 0.002, 0.011). Upper lumbar lordosis in the younger group changed dynamically in all changed positions compared with the old group (P = 0.019). Lower lumbar lordosis showed a decreasing pattern in both age groups, significantly changing as position changed from 30° to 60° (P = 0.007, 0.007). Lumbar lordosis decreases as position changes from standing to 90°sitting. The upper lumbar spine is more flexible in individuals in their twenties compared to those in their sixties. Changes in lumbar lordosis were concentrated in the lower lumbar region in the older group in sitting positions.
Tài liệu tham khảo
Adams MA: The Biomechanics of Back Pain. 2012, Edinburgh: Elsevier, 3
Adams MA, Dolan P, Hutton WC: The lumbar spine in backward bending. Spine. 1988, 13 (9): 1019-1026. 10.1097/00007632-198809000-00009.
Adams MA, Hutton WC: The effect of posture on the role of the apophysial joints in resisting intervertebral compressive forces. J Bone Joint Surg Br Vol. 1980, 62 (3): 358-362.
Umehara S, Zindrick MR, Patwardhan AG, Havey RM, Vrbos LA, Knight GW, Miyano S, Kirincic M, Kaneda K, Lorenz MA: The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine. 2000, 25 (13): 1617-1624. 10.1097/00007632-200007010-00004.
Gelb DE, Lenke LG, Bridwell KH, Blanke K, McEnery KW: An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine. 1995, 20 (12): 1351-1358.
Jackson RP, McManus AC: Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size: a prospective controlled clinical study. Spine. 1994, 19 (14): 1611-1618.
Wood KB, Kos P, Schendel M, Persson K: Effect of patient position on the sagittal-plane profile of the thoracolumbar spine. J Spinal Disord. 1996, 9 (2): 165-169.
Fotoohabadi MR, Tully EA, Galea MP: Kinematics of rising from a chair: image-based analysis of the sagittal hip-spine movement pattern in elderly people who are healthy. Phys Ther. 2010, 90 (4): 561-571. 10.2522/ptj.20090093.
Burton AK: Measurement of "regional" lumbar sagittal mobility. J Orthop Sports Physical Ther. 1987, 9 (4): 166-169. 10.2519/jospt.1987.9.4.166.
Sullivan MS, Dickinson CE, Troup JD: The influence of age and gender on lumbar spine sagittal plane range of motion: a study of 1126 healthy subjects. Spine. 1994, 19 (6): 682-686.
Lee CS, Chung SS, Kang KC, Park SJ, Shin SK: Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population. Spine. 2011, 36 (25): E1648-E1654. 10.1097/BRS.0b013e318216b0fd.
Standards KAT: Report on the 5th Human Body Measurement of Korean. 2004, Gyeonggi-do, Korea: Ergonomics Society of Korea
Andersson GB, Murphy RW, Ortengren R, Nachemson AL: The influence of backrest inclination and lumbar support on lumbar lordosis. Spine. 1979, 4 (1): 52-58. 10.1097/00007632-197901000-00009.
Stagnara P, De Mauroy JC, Dran G, Gonon GP, Costanzo G, Dimnet J, Pasquet A: Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine. 1982, 7 (4): 335-342. 10.1097/00007632-198207000-00003.
Benzel EC, Francis TB: Spine Surgery: Techniques, Complication Avoidance, and Management. 2012, Philadelphia, PA: Elsevier/Saunders, 3
Hansson T, Bigos S, Beecher P, Wortley M: The lumbar lordosis in acute and chronic low-back pain. Spine. 1985, 10 (2): 154-155. 10.1097/00007632-198503000-00008.
Bernhardt M, Bridwell KH: Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine. 1989, 14 (7): 717-721. 10.1097/00007632-198907000-00012.
Tan Y, Aghdasi BG, Montgomery SR, Inoue H, Lu C, Wang JC: Kinetic magnetic resonance imaging analysis of lumbar segmental mobility in patients without significant spondylosis. Eur Spine J. 2012, 21 (12): 2673-2679. 10.1007/s00586-012-2387-8.
Kozanek M, Wang S, Passias PG, Xia Q, Li G, Bono CM, Wood KB: Range of motion and orientation of the lumbar facet joints in vivo. Spine. 2009, 34 (19): E689-E696. 10.1097/BRS.0b013e3181ab4456.
Lawrence JS: Disc degeneration. Its frequency and relationship to symptoms. Ann Rheum Dis. 1969, 28 (2): 121-138.
Oh YM, Eun JP: The relationship between sagittal spinopelvic parameters and the degree of lumbar intervertebral disc degeneration in young adult patients with low-grade spondylolytic spondylolisthesis. Bone Joint J. 2013, 95-B (9): 1239-1243. 10.1302/0301-620X.95B9.31717.
Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009, 41 (4): 1149-1160. 10.3758/BRM.41.4.1149.
Prieto L, Lamarca R, Casado A: Assessment of the reliability of clinical findings: the intraclass correlation coefficient. Med Clin (Barc). 1998, 110 (4): 142-145.
Takeda N, Kobayashi T, Atsuta Y, Matsuno T, Shirado O, Minami A: Changes in the sagittal spinal alignment of the elderly without vertebral fractures: a minimum 10-year longitudinal study. J Orthop Sci Offic J Jpn Orthop Assoc. 2009, 14 (6): 748-753. 10.1007/s00776-009-1394-z.
Hammerberg EM, Wood KB: Sagittal profile of the elderly. J Spinal Disord Tech. 2003, 16 (1): 44-50. 10.1097/00024720-200302000-00008.
Kobayashi T, Atsuta Y, Matsuno T, Takeda N: A longitudinal study of congruent sagittal spinal alignment in an adult cohort. Spine. 2004, 29 (6): 671-676. 10.1097/01.BRS.0000115127.51758.A2.
Galbusera F, Brayda-Bruno M, Costa F, Wilke HJ: Numerical evaluation of the correlation between the normal variation in the sagittal alignment of the lumbar spine and the spinal loads. J Orthop Res. 2014, 32 (4): 537-544. 10.1002/jor.22569.
Galbusera F, Wilke HJ, Brayda-Bruno M, Costa F, Fornari M: Influence of sagittal balance on spinal lumbar loads: a numerical approach. Clin Biomech. 2013, 28 (4): 370-377. 10.1016/j.clinbiomech.2013.02.006.
Rodriguez-Soto AE, Jaworski R, Jensen A, Niederberger B, Hargens AR, Frank LR, Kelly KR, Ward SR: Effect of load carriage on lumbar spine kinematics. Spine. 2013, 38 (13): E783-E791. 10.1097/BRS.0b013e3182913e9f.
Dolan P, Adams MA, Hutton WC: Commonly adopted postures and their effect on the lumbar spine. Spine. 1988, 13 (2): 197-201. 10.1097/00007632-198802000-00012.
Adams MA, Dolan P, Marx C, Hutton WC: An electronic inclinometer technique for measuring lumbar curvature. Clin Biomech. 1986, 1 (3): 130-134. 10.1016/0268-0033(86)90002-1.
Polster J, Schwering-Leesch UM: Biomechanics of clinical symptoms caused by inflammatory diseases of the cervical spine and their therapy (author's transl). Orthopade. 1981, 10 (2): 169-177.
Koreska J, Robertson D, Mills RH, Gibson DA, Albisser AM: Biomechanics of the lumbar spine and its clinical significance. Orthop Clin North Am. 1977, 8 (1): 121-133.