El Fegoun Abdelkrim Benchikh, Schwab Frank, Gamez Lorenzo, Champain Nicolas, Skalli Wafa, Farcy Jean-Pierre
Spine Center, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Spine (Phila Pa 1976). 2005 Jul 1;30(13):1535-40. doi: 10.1097/01.brs.0000167534.49069.e9.
This is a prospective radiographic and force plate analysis involving adult volunteer and patients with scoliosis.
To assess accurately the center of pressure in standing volunteers and patients with scoliosis, and correlate these finding with radiographic data.
A simple and commonly applied parameter of global balance is the plumbline offset. This radiographic measurement refers to the center of C2 (or C7) drawn vertically downward. Although this measurement is simple, it may not accurately reflect the balance of the spine.
This study included adult volunteers (n = 41) and patients with scoliosis (n = 45). Full-length, freestanding spine radiographs were obtained with subjects on a force plate. Simultaneous assessment of the radiologic spinal posture and the floor projection of the center of pressure (gravity line) was possible. The latter was projected on the full spine images and correlated to common radiographic parameters.
The position of the gravity line differed significantly from the plumbline in frontal and sagittal planes (P < 0.001). This difference was maintained in both study populations. The mean frontal plane alignment of the gravity line was consistently to the right of the plumbline. The mean sagittal plane alignment of the gravity in relation to the plumbline revealed an offset anteriorly.
The data analysis of offsets between the gravity line and radiographic parameters revealed a frontal plane mean displacement of the gravity line to the right. In the sagittal plane, a highly significant lack of correlation between the gravity line and plumbline was noted. The plumbline represents a common and convenient visual display of apparent sagittal plane imbalance, but its value as a marker of true postural balance must be questioned.
这是一项涉及成年志愿者和脊柱侧弯患者的前瞻性影像学和测力板分析。
准确评估站立的志愿者和脊柱侧弯患者的压力中心，并将这些发现与影像学数据相关联。
全球平衡的一个简单且常用的参数是铅垂线偏移。这种影像学测量是指从C2（或C7）中心垂直向下绘制。尽管这种测量很简单，但它可能无法准确反映脊柱的平衡。
本研究纳入成年志愿者（n = 41）和脊柱侧弯患者（n = 45）。让受试者站在测力板上获取全长、独立的脊柱X线片。可以同时评估放射学上的脊柱姿势和压力中心（重力线）的地面投影。后者投影到全脊柱图像上，并与常见的影像学参数相关联。
重力线的位置在额面和矢状面与铅垂线有显著差异（P < 0.001）。在两个研究人群中这种差异均存在。重力线在额面的平均对齐始终在铅垂线右侧。重力线相对于铅垂线在矢状面的平均对齐显示向前偏移。
重力线与影像学参数之间偏移的数据分析显示，重力线在额面平均向右移位。在矢状面，注意到重力线与铅垂线之间存在高度显著的不相关性。铅垂线是明显矢状面失衡的一种常见且方便的视觉展示，但它作为真正姿势平衡标志物的价值值得质疑。
