骨盆支具对骨盆后向运动学的影响:一项体外生物力学研究。

Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study.

机构信息

Orthopaedicus Clinics, Leipzig, Germany.

Department of Orthopedic and Trauma Surgery, University Clinics of Leipzig, Leipzig, Germany.

出版信息

Sci Rep. 2018 Oct 29;8(1):15980. doi: 10.1038/s41598-018-34387-7.

Abstract

The sacroiliac joint (SIJ) is a well-known source of low back pain, with increasing interest for both conservative and surgical treatment. Alterations in pelvis kinematics are hypothesized as a contributor to SIJ pain and pelvic orthoses one treatment option, but their effects on the pelvis are poorly understood. Alterations in movement patterns induced by the application of pelvic orthoses were determined in five human cadaveric pelvises. Deformations were obtained from the lumbosacral transition and the bilateral SIJ, using digital image correlation and a customized routine to compute the movements within the pelvis. Significant alterations were found for the movements at the SIJ, in particular a vast increase in axial (x-axis) rotation, accompanied by increased inferior (y-) translation of the sacrum relative to the ilium. Movement patterns at the lumbosacral transition changed, causing increases in axial rotation and decreased inferior translation of L5 relative to S1. Using a physiologic mode of load application gives novel insights into the potential effects of pelvic orthoses. The results of these in-vitro experiments vary markedly from previous experiments with loading limited to two or less axes. Furthermore, the influence of pelvic orthoses on the lumbosacral transition warrants further investigation.

摘要

骶髂关节(SIJ)是引起下腰痛的一个众所周知的部位,无论是保守治疗还是手术治疗,人们对其的关注度都日益增加。骨盆运动学的改变被认为是 SIJ 疼痛的一个促成因素,骨盆矫形器是一种治疗选择,但人们对其对骨盆的影响知之甚少。本研究在 5 具人体尸体骨盆上确定了应用骨盆矫形器后运动模式的改变。使用数字图像相关技术和定制的程序,从腰骶过渡区和双侧 SIJ 获得变形,以计算骨盆内的运动。在 SIJ 的运动中发现了明显的改变,特别是轴向(x 轴)旋转的大幅增加,伴随着骶骨相对于髂骨的下(y)向平移增加。腰骶过渡区的运动模式发生改变,导致 L5 相对于 S1 的轴向旋转增加,下向平移减少。使用生理负荷施加模式为骨盆矫形器的潜在影响提供了新的见解。这些体外实验的结果与以前的实验结果有很大的不同,以前的实验仅限于两个或更少的轴的加载。此外,骨盆矫形器对腰骶过渡区的影响值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/105a/6206162/e002e5ffed02/41598_2018_34387_Fig1_HTML.jpg

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