Park Ki Hoon, Baek Sora, Kang Eun Kyoung, Park Hee-Won, Kim Gowun, Kim Sung Hyun
Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Center for Farmers' Safety and Health and Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Ann Rehabil Med. 2021 Aug;45(4):294-303. doi: 10.5535/arm.21037. Epub 2021 Aug 30.
OBJECTIVE: To investigate whether lumbar lordosis (LL) and lumbar segmental lordosis (LSL) are related to sex, age, low back pain (LBP), and lumbar disc space narrowing (DSN). METHODS: A total of 569 farmers were recruited. In lateral spine radiograph, LL (L1-L5) and LSL (L1, L2, L3, L4, and L5) were measured using Cobb's method. The differences in LSL values (ΔLSL) according to the presence or absence of a DSN were calculated as LSLDSN - LSLnoDSN for each DSN level. RESULTS: In male, the lateral spine radiograph showed significantly greater L4-LSL and L5-LSL and smaller L1-LSL and L2-LSL compared to female. LLs in the 50-59 and ≥60 years age groups were significantly smaller compared to those in the <50 years age group. In subjects with LBP, LL and L4-LSL were significantly smaller than in those without. The ΔLSLs at the disc level with DSN showed the greatest decrease: L1-ΔLSL (Δ-3.99°), L2-ΔLSL (Δ-3.31°), L3-ΔLSL (Δ-2.87°), L4-ΔLSL (Δ-3.31°), and L5-ΔLSL (Δ-4.44°) in L1/2, L2/3, L3/4, L4/5, and L5/S1 DSN, respectively. Conversely, distant ΔLSLs were inversely increased: L1-LSL (Δ0.75°) with L4/5 DSN and L2-LSL (Δ0.94°) with L5/S1 DSN. CONCLUSION: Sagittal plane alignment was significantly associated with sex, age, LBP, and DSN. LSLs around the levels of DSN were decreased, and there was compensational increase of LSL distant to the DSN to maintain the overall LL.
目的:探讨腰椎前凸(LL)和腰椎节段性前凸(LSL)是否与性别、年龄、腰痛(LBP)及腰椎间盘间隙狭窄(DSN)相关。 方法:共招募569名农民。在脊柱侧位X线片上,采用Cobb法测量LL(L1 - L5)和LSL(L1、L2、L3、L4和L5)。根据有无DSN计算各DSN水平下LSL值的差异(ΔLSL),即LSLDSN - LSLnoDSN。 结果:男性脊柱侧位X线片显示,与女性相比,L4 - LSL和L5 - LSL显著更大,而L1 - LSL和L2 - LSL更小。50 - 59岁及≥60岁年龄组的LL显著小于<50岁年龄组。有LBP的受试者中,LL和L4 - LSL显著小于无LBP者。DSN椎间盘水平的ΔLSL下降最为明显:L1/2、L2/3、L3/4、L4/5和L5/S1 DSN中,L1 - ΔLSL(Δ - 3.99°)、L2 - ΔLSL(Δ - 3.31°)、L3 - ΔLSL(Δ - 2.87°)、L4 - ΔLSL(Δ - 3.31°)和L5 - ΔLSL(Δ - 4.44°)。相反,远处的ΔLSL呈反向增加:L4/5 DSN时L1 - LSL(Δ0.75°),L5/S1 DSN时L2 - LSL(Δ0.94°)。 结论:矢状面排列与性别、年龄、LBP和DSN显著相关。DSN水平周围的LSL下降,而远离DSN的LSL有代偿性增加以维持整体LL。
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