Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
Clin Biomech (Bristol). 2021 Mar;83:105291. doi: 10.1016/j.clinbiomech.2021.105291. Epub 2021 Feb 9.
Intervertebral disc degeneration affects the morphology, biomechanics and biochemistry of the disc. The study aimed to compare the effects of compression and traction on lumbar discs measurements in relation to degeneration.
Thirty-five volunteers (30 (SD 11) yrs.) with and without chronic back pain rested supine 15 min before an unloaded T-mapping MRI, were then loaded 20 min with 50% body weight with imaging during the last 5 min, and then repeated this process under traction. For lumbar discs, height, angle, width, mean-T, and T-weighted centroid locations were calculated. A repeated measure ANCOVA and Cohen's d compared loading conditions. Relations between measurement changes between conditions and degeneration assessed by Pfirrmann ratings were examined graphically.
From compression to traction, we observed significant: decrease in L1-2 mean-T (Effect size = -0.35); inferior and posterior shift in L4-5 (0.4, 0.14) and L5-S1 (0.25, 0.33) T-weighted centroid. From unloaded to compression, we observed a significant: increase in L5-S1 width (Effect Size = 0.22); anterior shift in L1-2 T-weighted centroid (0.39); and L3-4 (mean 2.1°) and L4-5 (1.8°) extension angle. More degeneration was graphically related with larger changes from Compression to Traction (more superior and, anterior position of the T-weighted centroid, increased height, reduced extension of segmental angle) and from Unloaded to Compression larger changes in inferior displacement of the Tweighted centroid, decrease in height) but less anterior displacement of the centroid and less change in segmental angles.
The largest loading responses were at lower levels, generally with more degeneration. T-weighted centroid locations, angle and disc height detected the largest loading response.
椎间盘退变影响椎间盘的形态、生物力学和生物化学。本研究旨在比较压缩和牵引对椎间盘退变的影响。
35 名志愿者（30 岁（标准差 11 岁）），有无慢性腰痛，在未负重 T 映射 MRI 前仰卧位休息 15 分钟，然后在 5 分钟内用 50%体重加载 20 分钟，并在牵引下重复此过程。对于腰椎间盘，计算高度、角度、宽度、平均 T 值和 T 加权质心位置。重复测量方差分析和 Cohen's d 比较加载条件。通过 Pfirrmann 评分评估测量值在不同条件之间的变化与退变之间的关系。
从压缩到牵引，我们观察到 L1-2 平均 T 值显著降低（效应量为-0.35）；L4-5（0.4，0.14）和 L5-S1（0.25，0.33）T 加权质心向后下移位。从无负荷到压缩，我们观察到 L5-S1 宽度显著增加（效应大小为 0.22）；L1-2 T 加权质心向前移位（0.39）；L3-4（平均 2.1°）和 L4-5（1.8°）伸展角度增加。更多的退变与从压缩到牵引时 T 加权质心的更大变化（更向上和向前的位置、更高的高度、节段角度的伸展减少）以及从无负荷到压缩时 T 加权质心的更大下位移、高度降低）有关，但质心的前移位较小，节段角度的变化较小。
最大的加载响应发生在较低的水平，通常与更多的退变有关。T 加权质心位置、角度和椎间盘高度检测到最大的加载响应。
