Department of Physical Activity and Sport, University of Murcia, Murcia, Spain.
Department of Rehabilitation Sciences and Physiotherapy, Albacete University Hospital Complex, Albacete, Spain.
J Back Musculoskelet Rehabil. 2020;33(6):1003-1014. doi: 10.3233/BMR-191727.
The child's spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP).
The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children.
This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children's parents or legal guardians filled in a questionnaire according to the children's responses about the BP suffered in the previous week and the preceding year.
The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009-1.160, p= 0.028).
To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.
儿童在生长过程中，脊柱的姿势和曲度平衡会发生变化，骨骼肌肉脊柱状况可能会发展，例如背痛（BP）。
本研究的目的是（a）描述放松站立位时的矢状脊柱排列，（b）分析其与 8 至 12 岁儿童背痛（BP）之间的关系。
这是一项横断面研究。共有来自 16 所西班牙学校的 731 名小学生（379 名女孩和 352 名男孩）参与了研究。使用单水平倾斜计在放松站立位时测量矢状脊柱曲率（胸椎和腰椎）。根据性别、年龄、体重、身高和 BMI 分析矢状脊柱形态。儿童的父母或法定监护人根据儿童在前一周和前一年报告的 BP 情况填写问卷。
胸椎后凸角的平均角度为 36.08 ± 8.99∘，男性明显高于女性（p= 0.036）。相反，腰椎前凸角的平均值为 32.11 ± 7.46∘，女性明显高于男性（p< 0.01）。胸椎曲线随年龄增长而增加（p= 0.003）。前一周有下背痛（LBP）的儿童的腰椎曲线明显较大（35.88 ± 8.20∘），而前一周没有 LBP 的儿童的腰椎曲线较小（32.24 ± 7.30∘）。腰椎曲度是评估儿童 LBP 发生的一个小的预测因素（OR = 1.082 [小]；95% CI = 1.009-1.160，p= 0.028）。
总之，近 3/4 的学生被归类为正常胸椎后凸；然而，27.36%的学生有胸椎过度后凸。在学生中发现 9.05%的腰椎过度前凸，女性发病率是男性的 2.5 倍。腰椎曲度是评估儿童 LBP 发生的一个小的预测因素，最准确识别发生 LBP 风险的个体的腰椎曲度角度确定为 33∘。本研究结果表明，在发育年龄阶段，需要在学校评估矢状脊柱曲度。
