Physical Therapy Department, Zefat Academic College, Safed, Israel; Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Spine J. 2014 Jan;14(1):87-97. doi: 10.1016/j.spinee.2013.07.464. Epub 2013 Oct 2.
Lumbar lordosis is a key postural component that has interested both clinicians and researchers for many years. Despite its wide use in assessing postural abnormalities, there remain many unanswered questions regarding lumbar lordosis measurements. Therefore, in this article we reviewed different factors associated with the lordosis angle based on existing literature and determined normal values of lordosis. We reviewed more than 120 articles that measure and describe the different factors associated with the lumbar lordosis angle. Because of a variety of factors influencing the evaluation of lumbar lordosis such as how to position the patient and the number of vertebrae included in the calculation, we recommend establishing a uniform method of evaluating the lordosis angle. Based on our review, it seems that the optimal position for radiologic measurement of lordosis is standing with arms supported while shoulders are flexed at a 30° angle. There is evidence that many factors, such as age, gender, body mass index, ethnicity, and sport, may affect the lordosis angle, making it difficult to determine uniform normal values. Normal lordosis should be determined based on the specific characteristics of each individual; we therefore presented normal lordosis values for different groups/populations. There is also evidence that the lumbar lordosis angle is positively and significantly associated with spondylolysis and isthmic spondylolisthesis. However, no association has been found with other spinal degenerative features. Inconclusive evidence exists for association between lordosis and low back pain. Additional studies are needed to evaluate these associations. The optimal lordotic range remains unknown and may be related to a variety of individual factors such as weight, activity, muscular strength, and flexibility of the spine and lower extremities.
腰椎前凸是一种重要的姿势组成部分，多年来一直引起临床医生和研究人员的兴趣。尽管在评估姿势异常方面广泛使用，但对于腰椎前凸测量仍存在许多未解答的问题。因此，在本文中，我们根据现有文献综述了与前凸角相关的不同因素，并确定了前凸的正常值。我们综述了 120 多篇测量和描述与腰椎前凸角相关的不同因素的文章。由于影响腰椎前凸评估的因素很多，例如如何定位患者以及计算中包含的椎骨数量，因此我们建议建立评估前凸角的统一方法。根据我们的综述，似乎放射学测量前凸的最佳体位是站立位，手臂支撑，同时肩部弯曲 30°。有证据表明，许多因素，如年龄、性别、体重指数、种族和运动，可能会影响前凸角，使得难以确定统一的正常值。正常前凸应根据每个人的具体特征来确定；因此，我们为不同的群体/人群提供了正常前凸值。也有证据表明，腰椎前凸角与脊椎裂和峡部裂性脊椎滑脱呈正相关，与其他脊柱退行性特征无关联。前凸与腰痛之间的关联存在不确定的证据。需要进一步的研究来评估这些关联。最佳前凸范围尚不清楚，可能与体重、活动、脊柱和下肢的肌肉力量和柔韧性等多种个体因素有关。
