Dreischarf Marcel, Albiol Laia, Rohlmann Antonius, Pries Esther, Bashkuev Maxim, Zander Thomas, Duda Georg, Druschel Claudia, Strube Patrick, Putzier Michael, Schmidt Hendrik
Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Germany.
PLoS One. 2014 Dec 30;9(12):e116186. doi: 10.1371/journal.pone.0116186. eCollection 2014.
The understanding of the individual shape and mobility of the lumbar spine are key factors for the prevention and treatment of low back pain. The influence of age and sex on the total lumbar lordosis and the range of motion as well as on different lumbar sub-regions (lower, middle and upper lordosis) in asymptomatic subjects still merits discussion, since it is essential for patient-specific treatment and evidence-based distinction between painful degenerative pathologies and asymptomatic aging.
A novel non-invasive measuring system was used to assess the total and local lumbar shape and its mobility of 323 asymptomatic volunteers (age: 20-75 yrs; BMI <26.0 kg/m2; males/females: 139/184). The lumbar lordosis for standing and the range of motion for maximal upper body flexion (RoF) and extension (RoE) were determined. The total lordosis was significantly reduced by approximately 20%, the RoF by 12% and the RoE by 31% in the oldest (>50 yrs) compared to the youngest age cohort (20-29 yrs). Locally, these decreases mostly occurred in the middle part of the lordosis and less towards the lumbo-sacral and thoraco-lumbar transitions. The sex only affected the RoE.
During aging, the lower lumbar spine retains its lordosis and mobility, whereas the middle part flattens and becomes less mobile. These findings lay the ground for a better understanding of the incidence of level- and age-dependent spinal disorders, and may have important implications for the clinical long-term success of different surgical interventions.
了解腰椎的个体形态和活动度是预防和治疗腰痛的关键因素。年龄和性别对无症状受试者的腰椎前凸总和、活动范围以及不同腰椎亚区域（下腰椎前凸、中腰椎前凸和上腰椎前凸）的影响仍值得探讨，因为这对于针对患者的治疗以及区分疼痛性退行性病变和无症状性衰老的循证医学依据至关重要。
采用一种新型非侵入性测量系统评估了323名无症状志愿者（年龄：20 - 75岁；体重指数<26.0 kg/m²；男性/女性：139/184）的腰椎整体和局部形态及其活动度。测定了站立位腰椎前凸以及上半身最大前屈（RoF）和后伸（RoE）的活动范围。与最年轻年龄组（20 - 29岁）相比，年龄最大组（>50岁）的腰椎前凸总和显著降低约20%，RoF降低12%，RoE降低31%。在局部，这些降低主要发生在腰椎前凸的中部，向腰骶部和胸腰段交界处的降低较少。性别仅影响RoE。
在衰老过程中，下腰椎保持其前凸和活动度，而中部变平且活动度降低。这些发现为更好地理解与水平和年龄相关的脊柱疾病的发病率奠定了基础，并且可能对不同手术干预的临床长期成功具有重要意义。
