Mizukoshi Ryo, Yagi Mitsuru, Yamada Yoshitake, Yokoyama Yoichi, Yamada Minoru, Watanabe Kota, Nakamura Masaya, Nagura Takeo, Jinzaki Masahiro
Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan.
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.
Sci Rep. 2024 Apr 21;14(1):9154. doi: 10.1038/s41598-024-59840-8.
Lumbar spinal alignment is crucial for spine biomechanics and is linked to various spinal pathologies. However, limited research has explored gender-specific differences using CT scans. The objective was to evaluate and compare lumbar spinal alignment between standing and sitting CT in healthy individuals, focusing on gender differences. 24 young and 25 elderly males (M) and females (F) underwent standing and sitting CT scans to assess lumbar spinal alignment. Parameters measured and compared between genders included lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lordotic angle (LA), foraminal height (FH), and bony boundary area (BBA). Females showed significantly larger changes in SS and PT when transitioning from standing to sitting (p = .044, p = .038). A notable gender difference was also observed in the L4-S LA among the elderly, with females showing a significantly larger decrease in lordotic angle compared to males (- 14.1° vs. - 9.2°, p = .039*). Females consistently exhibited larger FH and BBA values, particularly in lower lumbar segments, which was more prominent in the elderly group (M vs. F: L4/5 BBA 80.1 mm [46.3, 97.8] vs. 109.7 mm [74.4, 121.3], p = .019 in sitting). These findings underline distinct gender-related variations in lumbar alignment and flexibility, with a focus on noteworthy changes in BBA and FH in females. Gender differences in lumbar spinal alignment were evident, with females displaying greater pelvic and sacral mobility. Considering gender-specific characteristics is crucial for assessing spinal alignment and understanding spinal pathologies. These findings contribute to our understanding of lumbar spinal alignment and have implications for gender-specific spinal conditions and treatments.
腰椎排列对脊柱生物力学至关重要，且与多种脊柱病变相关。然而，利用CT扫描探索性别差异的研究有限。目的是评估和比较健康个体站立位和坐位CT下的腰椎排列，重点关注性别差异。24名年轻男性和女性以及25名老年男性和女性接受了站立位和坐位CT扫描以评估腰椎排列。测量并比较的性别相关参数包括腰椎前凸（LL）、骶骨倾斜度（SS）、骨盆倾斜度（PT）、骨盆入射角（PI）、前凸角（LA）、椎间孔高度（FH）和骨边界面积（BBA）。女性从站立位转变为坐位时，SS和PT的变化显著更大（p = 0.044，p = 0.038）。在老年人中，L4 - S节段的LA也观察到显著的性别差异，女性的前凸角减小幅度明显大于男性（-14.1°对-9.2°，p = 0.039*）。女性的FH和BBA值始终较大，尤其是在腰椎下段，在老年组中更为明显（男性与女性：L4/5节段BBA，坐位时80.1 mm [46.3，97.8]对109.7 mm [74.4，121.3]，p = 0.019）。这些发现强调了腰椎排列和柔韧性方面明显的性别相关差异，重点是女性BBA和FH的显著变化。腰椎排列的性别差异明显，女性表现出更大的骨盆和骶骨活动度。考虑性别特异性特征对于评估脊柱排列和理解脊柱病变至关重要。这些发现有助于我们理解腰椎排列，并对性别特异性脊柱疾病和治疗具有启示意义。
