Kamata Kumi, Ozawa Hiroshi, Sekiguchi Yusuke, Aizawa Toshimi, Izumi Shinichi, Itoi Eiji
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine. 1-1 Seiryomachi Aobaku, Sendai, Miyagi, 980-8574, Japan; Department of Orthopaedic Surgery, Iwaki Kyoritsu Hospital. 16 Utigo Mimayamachi Kusehara, Iwakishi, Fukushima, 973-8555, Japan.
Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro Miyaginoku, Sendai, Miyagi, 983-8536, Japan.
J Orthop Sci. 2019 Sep;24(5):793-797. doi: 10.1016/j.jos.2019.01.005. Epub 2019 Feb 6.
Patients with spinal kyphosis were radiographically evaluated while standing. However, the spino-pelvic alignment during walking is different. This study examined the spino-pelvic-lower extremity alignment during walking by a three-dimensional (3D) motion analysis.
Twenty-six patients with a sagittal vertical axis of ≥4 cm (male: female, 5:21; average age, 66 years) were evaluated. Using a 3D motion capture system, the trunk and pelvic anterior inclination angles, hip and knee joint angles were measured during a 3-min walk. The correlation coefficient between the change of the trunk anterior inclination angle and each parameter at the beginning of walking was calculated, and those parameters were compared with radiographic measurements.
The patients were divided into two groups according to the change of the trunk anterior inclination angle: the large change group included 14 patients with an increase of ≥5° between the beginning and end of the 3-min walk; the small change group included 12 patients with an increase of <5°. The pelvic anterior inclination angle showed a significant difference between the two groups at the first gait cycles. The pelvic anterior inclination angle and the hip joint angle in the large change group showed a significant difference between the first and last cycles. The correlation coefficient revealed a significant association between the change in the trunk anterior inclination angle and the pelvic anterior inclination angle at the beginning of walking. There were no significant differences between the two groups in any radiographic spino-pelvic parameters.
There were two types of patients with spinal kyphosis: patients with a small pelvic anterior inclination angle at the beginning of walking showed slight progression in their trunk anterior inclination, whereas those with a large pelvic angle showed a large degree of progression in their pelvic and trunk inclination during walking.
脊柱后凸患者在站立位时接受了影像学评估。然而，行走过程中的脊柱-骨盆对线情况有所不同。本研究通过三维（3D）运动分析检查了行走过程中的脊柱-骨盆-下肢对线情况。
对26例矢状垂直轴≥4 cm的患者（男∶女 = 5∶21；平均年龄66岁）进行评估。使用3D运动捕捉系统，在3分钟步行过程中测量躯干和骨盆前倾角度、髋关节和膝关节角度。计算行走开始时躯干前倾角度变化与各参数之间的相关系数，并将这些参数与影像学测量结果进行比较。
根据躯干前倾角度变化将患者分为两组：大变化组包括14例在3分钟步行开始和结束时增加≥5°的患者；小变化组包括12例增加<5°的患者。在第一个步态周期，两组之间的骨盆前倾角度存在显著差异。大变化组的骨盆前倾角度和髋关节角度在第一个和最后一个周期之间存在显著差异。相关系数显示行走开始时躯干前倾角度变化与骨盆前倾角度之间存在显著关联。两组在任何影像学脊柱-骨盆参数上均无显著差异。
脊柱后凸患者有两种类型：行走开始时骨盆前倾角度小的患者躯干前倾进展轻微，而骨盆角度大的患者在行走过程中骨盆和躯干倾斜进展程度大。
