Department of Bioengineering, University of California San Diego, La Jolla, CA, USA.
Doctor of Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA.
J Biomech. 2019 May 24;89:95-104. doi: 10.1016/j.jbiomech.2019.04.020. Epub 2019 Apr 18.
Understanding changes in lumbar spine (LS) angles and intervertebral disc (IVD) behavior in end-range positions in healthy subjects can provide a basis for developing more specific LS models and comparing people with spine pathology. The purposes of this study are to quantify 3D LS angles and changes in IVD characteristics with end-range positions in 3 planes of motion using upright MRI in healthy people, and to determine which intervertebral segments contribute most in each plane of movement. Thirteen people (average age = 24.4 years, range 18-51 years; 9 females; BMI = 22.4 ± 1.8 kg/m) with no history of low back pain were scanned in an upright MRI in standing, sitting flexion, sitting axial rotation (left, right), prone on elbows, prone extension, and standing lateral bending (left, right). Global and local intervertebral LS angles were measured. Anterior-posterior length of the IVD and location of the nucleus pulposus was measured. For the sagittal plane, lower LS segments contribute most to change in position, and the location of the nucleus pulposus migrated from a more posterior position in sitting flexion to a more anterior position in end-range extension. For lateral bending, the upper LS contributes most to end-range positions. Small degrees of intervertebral rotation (1-2°) across all levels were observed for axial plane positions. There were no systematic changes in IVD characteristics for axial or coronal plane positions.
了解健康受试者终末位时腰椎（LS）角度和椎间盘（IVD）行为的变化，可以为开发更具体的 LS 模型和比较脊柱病理患者提供基础。本研究的目的是使用直立 MRI 定量测量 3 个运动平面中终末位时 3D LS 角度和 IVD 特征的变化，并确定在每个运动平面中哪些椎间节段贡献最大。13 名无腰痛病史的健康人（平均年龄 24.4 岁，年龄 18-51 岁；9 名女性；BMI 22.4 ± 1.8 kg/m）分别在站立位、坐位前屈位、坐位左右轴向旋转位、肘俯位、坐位伸展位和站立位左右侧屈位接受直立 MRI 扫描。测量了 LS 全局和局部角度。测量了 IVD 的前后长度和核髓位置。在矢状面，下位 LS 节段对位置变化的贡献最大，核髓位置从坐位前屈的更后位置迁移到终末伸展的更前位置。对于侧屈，上位 LS 对终末位的贡献最大。在轴向平面位置观察到所有水平的小度数的椎间旋转（1-2°）。轴向或冠状平面位置的 IVD 特征没有系统变化。
