Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
Tohoku J Exp Med. 2010 May;221(1):53-9. doi: 10.1620/tjem.221.53.
Chronic low back pain (LBP) is influenced by numerous factors and often shows a decline in walking abilities. However, the impact of spinal alignment and mobility on this condition and walking disturbance in the general population is unclear. A total of 672 community-dwelling individuals aged 20-94 years (mean, 69 years) in Kamikoani, Akita, Japan were divided into four groups: controls, subjects with no history of LBP (n = 121); HLBP group, subjects with a history of LBP (n = 323); CLBP group, subjects with chronic LBP without walking disturbance (n = 89); and CLBP-WD group, subjects with chronic LBP with walking disturbance (n = 139). Differences among groups were investigated in terms of angle of kyphosis, mobility, and inclination of the spine in upright, flexed, and extended positions, all measured using a computer-assisted device. HLBP, CLBP, and CLBP-WD groups showed significantly limited lumbar extension compared to controls (P < 0.05). The CLBP-WD group showed significantly increased thoracic and lumbar kyphosis angles and spinal inclination compared to the other groups (P < 0.05). Among subjects with chronic LBP (CLBP and CLBP-WD groups), associations between walking disturbance and measured variables were examined using logistic regression. According to multivariate analysis, lumbar kyphosis angle in upright position and spinal inclination in extended position were identified as indices associated with the presence of walking disturbance in subjects with chronic LBP. These results indicate that increased lumbar kyphosis and limitation of total spinal extension are important risk factors for walking disturbance in subjects with chronic LBP.
慢性下背痛（LBP）受多种因素影响，常表现为步行能力下降。然而，脊柱排列和活动度对这种情况以及普通人群中行走障碍的影响尚不清楚。在日本秋田县Kamikoani 的 672 名年龄在 20-94 岁（平均 69 岁）的社区居民中，将他们分为四组：对照组、无 LBP 病史的受试者（n = 121）；HLBP 组，有 LBP 病史的受试者（n = 323）；CLBP 组，无行走障碍的慢性 LBP 受试者（n = 89）；CLBP-WD 组，有行走障碍的慢性 LBP 受试者（n = 139）。使用计算机辅助设备测量直立、弯曲和伸展位置的脊柱后凸角度、活动度和倾斜度，比较各组之间的差异。HLBP、CLBP 和 CLBP-WD 组与对照组相比，腰椎伸展明显受限（P < 0.05）。CLBP-WD 组与其他组相比，胸椎和腰椎后凸角度以及脊柱倾斜度明显增加（P < 0.05）。在患有慢性 LBP 的受试者（CLBP 和 CLBP-WD 组）中，使用逻辑回归分析行走障碍与测量变量之间的关系。根据多变量分析，直立位腰椎后凸角度和伸展位脊柱倾斜度是慢性 LBP 受试者行走障碍存在的相关指标。这些结果表明，腰椎后凸增加和总脊柱伸展受限是慢性 LBP 受试者行走障碍的重要危险因素。
