Suzuki Hidekazu, Endo Kenji, Sawaji Yasunobu, Matsuoka Yuji, Nishimura Hirosuke, Takamatsu Taichiro, Murata Kazuma, Seki Takeshi, Konishi Takamitsu, Aihara Takato, Yamamoto Kengo
Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.
Spine Surg Relat Res. 2018 Mar 15;2(4):290-293. doi: 10.22603/ssrr.2017-0074. eCollection 2018 Oct 26.
Most people in modern societies spend the majority of their time sitting. However, sagittal spinal alignment is usually analyzed in the standing position. For understanding the symptoms associated with postural changes, this alignment is better to be analyzed in various positions. The purpose of this study was to investigate lumbo-pelvic relationships between standing up and sitting (sit-to-stand) motion.
The study subjects were 25 healthy young adult volunteers without any spinal symptoms. The following parameters were measured, namely, intervertebral range of motion (IV ROM), lumbar lordotic angle (L1L5), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI), on lateral whole-spine radiographs while sitting upright, sitting anterior flexed (anteflexed), standing anteflexed, and standing upright.
The measurements of spinopelvic parameters during sit-to-stand motion (sitting upright, sitting anteflexed, standing anteflexed, standing upright, respectively) were as follows: L1L5 (7.9, -4.4, 3.1, 31.9) and PT (31.5, 26.5, 11.9, 7.7). Regarding IV ROM, the lumbar segmental ROM after seat-off was wider than before seat-off (sitting anteflexed). In particular, the L4-L5 segments had a wide ROM from standing anteflexed to standing upright.
The pelvis was retroverted in the sitting upright position and gradually anteverted during sit-to-stand motion. Lumbar lordosis decreased in the sitting upright position, temporarily decreased further (sitting anteflexed), and then increased in the standing position (standing anteflexed and standing upright). The mechanical loads on lumbosacral segments were greater after seat-off due to the reverse movement between upper lumbar and pelvic segments.
现代社会中的大多数人大部分时间都坐着。然而，矢状面脊柱排列通常是在站立位进行分析的。为了理解与姿势变化相关的症状，最好在不同体位下分析这种排列情况。本研究的目的是调查站立和坐立（从坐到站）动作之间的腰骶关系。
研究对象为25名无任何脊柱症状的健康年轻成年志愿者。在侧位全脊柱X线片上测量以下参数，即椎间活动度（IV ROM）、腰椎前凸角（L1L5）、骶骨倾斜度（SS）、骨盆倾斜度（PT）和骨盆入射角（PI），测量时的体位分别为端坐位、前屈坐位、前屈站立位和直立站立位。
从坐到站动作过程中（分别为端坐位、前屈坐位、前屈站立位、直立站立位）的脊柱骨盆参数测量结果如下：L1L5（7.9、-4.4、3.1、31.9）和PT（31.5、26.5、11.9、7.7）。关于IV ROM，离座后的腰椎节段活动度比离座前（前屈坐位）更宽。特别是，L4-L5节段从前屈站立位到直立站立位有较宽的活动度。
在端坐位时骨盆后倾，在从坐到站的动作过程中逐渐前倾。腰椎前凸在端坐位时减小，在前屈坐位时暂时进一步减小，然后在站立位（前屈站立位和直立站立位）时增加。由于上位腰椎和骨盆节段之间的反向运动，离座后腰骶节段的机械负荷更大。
