Ochia Ruth S, Inoue Nozomu, Renner Susan M, Lorenz Eric P, Lim Tae-Hong, Andersson Gunnar B J, An Howard S
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA.
Spine (Phila Pa 1976). 2006 Aug 15;31(18):2073-8. doi: 10.1097/01.brs.0000231435.55842.9e.
Fifteen asymptomatic volunteers were externally rotated and CT scanned to determine lumbar segmental motion.
To measure three-dimensional segmental motion in vivo using a noninvasive measurement technique.
Spinal instability has been implicated as a potential cause of low back pain, especially, axial rotational instability. Typically, flexion-extension lateral radiographs were used to quantify instability, but inaccurately measured translations and inability to capture out-of-plane rotations are limitations.
Using a custom-calibrated rotation jig, L1-S1 CT reconstructions were created of volunteers in each of 3 positions: supine and left and right rotations of the torso with respect to the hips. Segmental motions were calculated using Euler angles and volume merge methods in three major planes.
Segmental motions were small (< 4 degrees or 6 mm) with the greatest motions seen in axial rotation (range, 0.6 degrees to 2.2 degrees ), lateral bending (range, -3.6 degrees to 3.0 degrees ), and frontal translation (-1.2 mm to 5.4 mm). Largest motions were in the levels: L1-L2 to L3-L4.
Complex coupled motions were measured due to external torsion and could be indicative of instability chronic patients with low back pain. The presented data provide baseline segmental motions for future comparisons to symptomatic subjects.
对15名无症状志愿者进行外旋并进行CT扫描，以确定腰椎节段运动。
使用非侵入性测量技术测量体内三维节段运动。
脊柱不稳被认为是下腰痛的潜在原因，尤其是轴向旋转不稳。通常，屈伸位侧位X线片用于量化不稳，但测量平移不准确且无法捕捉平面外旋转是其局限性。
使用定制校准的旋转夹具，对志愿者在三个位置（仰卧位以及躯干相对于臀部的左右旋转位）进行L1-S1的CT重建。在三个主要平面上使用欧拉角和体积合并方法计算节段运动。
节段运动较小（<4度或6毫米），其中轴向旋转（范围为0.6度至2.2度）、侧方弯曲（范围为-3.6度至3.0度）和额状面平移（-1.2毫米至5.4毫米）的运动最大。最大运动出现在L1-L2至L3-L4节段。
由于外部扭转测量到了复杂的耦合运动，这可能表明慢性下腰痛患者存在不稳。所呈现的数据为未来与有症状受试者的比较提供了节段运动基线。
