Department of Orthopedics, The Affiliated Hospital of Hebei University, Baoding, Hebei, China.
Department of Orthopedics, The Second Central Hospital of Baoding, Baoding, Hebei, China.
Surg Radiol Anat. 2022 Sep;44(9):1289-1295. doi: 10.1007/s00276-022-03005-7. Epub 2022 Aug 13.
Recognizing the kinematic characteristics of lumbar facet joints is important for the prevention and treatment of lumbar degenerative diseases. Previous studies have been conducted in either the supine or standing position, and there are no measurements regarding the kinematic characteristics of the lumbar facet joints while sitting. The aim of this study was to measure and analyze lumbar facet joint motion characteristics while sitting.
Ten subjects (5 males and 5 females) performed the movements of flexion-extension, left bending-right bending, and left rotation-right rotation in a sitting position. Dual Fluoroscopic Image System and computed tomography technique were used to measure the displacement and rotation angle of the lumbar facet joints of the subjects for analysis. The movement characteristics of L3-S1 were measured.
When the subjects were in sitting position, the lumbar vertebra mainly changed in Z-axis and α, β angle when they performed flexion-extension activities. The displacement of the left facet joint was 4.65 ± 1.99 mm at L3-4, 1.89 ± 2.99 mm at L4-5, and 0.80 ± 2.27 mm at L5-S1 in the Z-axis, and the displacement of the right facet joint was 3.20 ± 2.61 mm at L3-4, 1.71 ± 3.00 mm at L4-5, and 0.31 ± 1.69 mm at L5-S1 in the Z-axis. The rotation in the α angle was 6.00 ± 4.49° at L3-4, 3.51 ± 5.24° at L4-5, and 0.97 ± 4.13° at L5-S1, which was significant different. The rotation in the β angle was 2.30 ± 2.94°at L3-4, 0.16 ± 2.06° at L4-5, and 0.35 ± 1.74°at L5-S1, which was significant different. When the lumbar spine performed the activity of left bending-right bending, there were changes in rotation mainly in the Z-axis and β angle. The displacement of left facet joint in the Z-axis was 1.34 ± 2.84 mm at L3-4, 2.11 ± 0.88 mm at L4-5, and 0.72 ± 0.81 mm at L5-S1; the rotation in the β angle was 5.66 ± 2.70°at L3-4, 7.89 ± 2.59° at L4-5, and 1.28 ± 2.07° at L5-S1; when the lumbar spine performed the activity of left rotation-right rotation, there were changes in the β angle. The rotation of β angle was 4.09 ± 2.86° at L3-4, 2.14 ± 3.38° at L4-5, and 0.63 ± 1.85° at L5-S1.
The lumbar facet joint motion in sitting position is different in each mode of motion. The horizontal displacement and rotation are predominant during flexion and extension activities, while there are different rotation in bending and rotation. The study shows the coupled motion of the lumbar facet joints while sitting, providing a new perspective on the kinematics of the lumbar spine and the etiology of lumbar degenerative diseases.
认识腰椎小关节的运动学特征对于预防和治疗腰椎退行性疾病很重要。以往的研究都是在仰卧位或站立位进行的，而关于坐姿时腰椎小关节的运动学特征尚无测量数据。本研究旨在测量和分析坐姿时腰椎小关节的运动特征。
10 名受试者（5 男 5 女）分别进行了屈伸、左右侧弯和左右旋转的运动。使用双荧光透视图像系统和计算机断层扫描技术测量受试者的腰椎小关节的位移和旋转角度进行分析。测量了 L3-S1 的运动特征。
当受试者处于坐姿时，腰椎在屈伸运动中主要沿 Z 轴和α、β角变化。L3-4 节段左侧小关节的 Z 轴位移为 4.65±1.99mm，L4-5 节段为 1.89±2.99mm，L5-S1 节段为 0.80±2.27mm；右侧小关节的 Z 轴位移为 L3-4 节段 3.20±2.61mm，L4-5 节段 1.71±3.00mm，L5-S1 节段 0.31±1.69mm。α角旋转为 L3-4 节段 6.00±4.49°，L4-5 节段 3.51±5.24°，L5-S1 节段 0.97±4.13°，差异均有统计学意义。β角旋转为 L3-4 节段 2.30±2.94°，L4-5 节段 0.16±2.06°，L5-S1 节段 0.35±1.74°，差异均有统计学意义。当腰椎进行左右侧弯活动时，主要发生在 Z 轴和β角的旋转变化。L3-4 节段左侧小关节 Z 轴位移为 1.34±2.84mm，L4-5 节段为 2.11±0.88mm，L5-S1 节段为 0.72±0.81mm；β角旋转为 L3-4 节段 5.66±2.70°，L4-5 节段 7.89±2.59°，L5-S1 节段 1.28±2.07°；当腰椎进行左右旋转活动时，β角发生变化。β角的旋转为 L3-4 节段 4.09±2.86°，L4-5 节段 2.14±3.38°，L5-S1 节段 0.63±1.85°。
坐姿时腰椎小关节的运动方式不同。屈伸运动时以水平位移和旋转为主，左右侧弯和旋转运动时旋转角度不同。本研究显示了坐姿时腰椎小关节的耦合运动，为腰椎的运动学和腰椎退行性疾病的病因提供了新的视角。
