Du Peiyu, Yan Yuntao, Yin Shilin, Li Xi, Wang Hui, Sun Jiayuan, Kang Kai, Zhao Jianyong, Du Shuangqing
Department of Spine Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Orthopedics, The First Hospital of Hebei Chinese Medicine University, Shijiazhuang, Hebei, People's Republic of China.
Adv Ther. 2024 Jul;41(7):2924-2935. doi: 10.1007/s12325-024-02898-7. Epub 2024 Jun 4.
Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study required patients to use a standard standing posture and aimed to explore the relationship between coronal position of lumbar spine and WOMAC score in KOA.
This is a cross-sectional observational study. Data on a total of 268 patients with KOA were collected. Patients were photographed in a standard standing position and lumbar-sacrum offset distance (L-SOD) and lumbar-knee offset distance (ΔL-KOD) were calculated. Patients were then divided into different groups according to different critical values and differences were compared.
In the L-SOD of L1-3, WOMAC function (P = 0.021, P = 0.032, P = 0.001) and total score (P = 0.039, P = 0.034, P < 0.001) were different. In the L-SOD of L3-4, WOMAC pain score were different (P = 0.001, P = 0.032). At a cutoff of 13 mm, ΔL-KOD of L1-2 showed significant differences in pain part (P = 0.025, P = 0.039) and total score (P = 0.036, P = 0.050). There were significant differences in pain (P = 0.023, P = 0.027, P = 0.022), function (P = 0.048, P = 0.038, P = 0.047), and total score (P = 0.030, P = 0.027, P = 0.029) of L3-5. In the 18-mm cutoff group, only L1 and L2 have differences in the pain part (P = 0.050, P = 0.038).
Coronal balance of the lumbar spine is associated with knee pain and function. The pelvis plays an important role in maintaining the coronal balance. Both the lumbar spine and the knee joint should be considered when developing the surgical strategy.
脊柱矢状面序列已被证明与膝关节骨关节炎（KOA）相关，但冠状面序列与KOA之间的关系此前从未被研究过。本研究要求患者采用标准站立姿势，旨在探讨腰椎冠状位与KOA患者WOMAC评分之间的关系。
这是一项横断面观察性研究。共收集了268例KOA患者的数据。患者在标准站立位拍照，并计算腰骶偏移距离（L-SOD）和腰膝偏移距离（ΔL-KOD）。然后根据不同的临界值将患者分为不同组并比较差异。
在L1-3的L-SOD中，WOMAC功能（P = 0.021，P = 0.032，P = 0.001）和总分（P = 0.039，P = 0.034，P < 0.001）存在差异。在L3-4的L-SOD中，WOMAC疼痛评分存在差异（P = 0.001，P = 0.032）。在截断值为13mm时，L1-2的ΔL-KOD在疼痛部分（P = 0.025，P = 0.039）和总分（P = 0.036，P = 0.050）上显示出显著差异。L3-5在疼痛（P = 0.023，P = 0.027，P = 0.022）、功能（P = 0.048，P = 0.038，P = 0.047）和总分（P = 0.030，P = 0.027，P = 0.029）方面存在显著差异。在截断值为18mm的组中，仅L1和L2在疼痛部分存在差异（P = 0.050，P = 0.038）。
腰椎冠状面平衡与膝关节疼痛和功能相关。骨盆在维持冠状面平衡中起重要作用。制定手术策略时应同时考虑腰椎和膝关节。
