Dai Min, Li Xiaofeng, Zhou Xin, Hu Yiqiang, Luo Qiang, Zhou Song
Spine Surgery Department, The First Affiliated Hospital of Nanchang University, Yongwai Road, Nanchang, 330000, China,
Eur Spine J. 2015 Jun;24(6):1274-81. doi: 10.1007/s00586-015-3857-6. Epub 2015 Mar 10.
Women wearing high-heeled shoes have been considered to be more characterizing beauty, self-assurance and elegance. However, while maintaining the body on this type of support base, women with increased heel height often complain that wearing high-heeled shoes causes them to experience low back pain. The aim of the present study was to morphologically assess the effect of high-heel use on the static sagittal profile of the spino-pelvic structure.
A total of 21 Chinese girls were recruited in this study, with informed written consent. For each participant, standing left lateral radiographs, including that of the spine and pelvis, were obtained in a standardized standing position under barefoot and high-heel use conditions. The radiographic assessments were performed to detect the changes in the spino-pelvic profile under barefoot and high-heel use conditions.
The average lumbar lordosis (LL) was 54.3 ± 6.4º under the barefoot condition and increased to 65.2 ± 5.1º after high-heel use (P < 0.001), with a significant increase in the disc L5/S1 and disc L4/L5 tilt angles. Of the 21 participants, 15 (71.43 %) had an increased kyphosis value for thoracic kyphosis, and 6 (28.57 %) had a decreased value after high-heel use, with a significant increased mean kyphosis value of 3.4 ± 1.5º overall (P < 0.001). The sagittal vertical axis (SVA) was always positive and was worse after high-heel use (P = 0.012): 11.5 ± 8.7 mm under the barefoot condition and 29.8 ± 8.5 mm under the high-heel use condition. Bivariate correlation analysis showed that both ΔLL and ΔSVA were positively associated with the heel height of the shoes and were inversely associated with the age of the participants. Receiver operator characteristic analysis showed that a heel height >45.5 mm was strongly predictive of the loss of static sagittal balance of the spine during high-heel use (sensitivity 87.5 %, specificity 62.5 %, area under the curve: 0.773; P = 0.026).
The present study revealed that wearing high-heeled shoes can lead to increased LL and an uneconomic body position. This finding may help explain why some women complain that wearing high-heeled shoes causes them to experience low back pain.
穿高跟鞋的女性被认为更具美感、自信和优雅气质。然而，当身体以这种类型的支撑为基础时，鞋跟高度增加的女性经常抱怨穿高跟鞋会导致她们出现腰痛。本研究的目的是从形态学上评估穿高跟鞋对脊柱 - 骨盆结构静态矢状面轮廓的影响。
本研究共招募了21名中国女孩，并获得了她们的书面知情同意书。对于每位参与者，在赤脚和穿高跟鞋的条件下，于标准化站立位获取包括脊柱和骨盆的站立位左侧X线片。进行影像学评估以检测赤脚和穿高跟鞋条件下脊柱 - 骨盆轮廓的变化。
赤脚条件下平均腰椎前凸（LL）为54.3±6.4°，穿高跟鞋后增加至65.2±5.1°（P<0.001），L5/S1椎间盘和L4/L5椎间盘倾斜角度显著增加。21名参与者中，15名（71.43%）胸椎后凸值增加，6名（28.57%）穿高跟鞋后降低，总体平均后凸值显著增加3.4±1.5°（P<0.001）。矢状垂直轴（SVA）始终为正值，穿高跟鞋后更差（P = 0.012）：赤脚条件下为11.5±8.7mm，穿高跟鞋条件下为29.8±8.5mm。双变量相关性分析表明，ΔLL和ΔSVA均与鞋跟高度呈正相关，与参与者年龄呈负相关。受试者工作特征分析表明，鞋跟高度>45.5mm强烈预测穿高跟鞋期间脊柱静态矢状面平衡的丧失（敏感性87.5%，特异性62.5%，曲线下面积：0.773；P = 0.026）。
本研究表明，穿高跟鞋会导致LL增加和身体姿势不经济。这一发现可能有助于解释为什么一些女性抱怨穿高跟鞋会导致她们出现腰痛。
