Mills Emily S, Wang Jennifer C, Richardson Mary K, Chung Brian C, Mayer Lucas W, Gallo Matthew C, Alluri Ram K, Hah Raymond J, Heckmann Nathanael D
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Department of Orthopaedic Surgery, Keck Medical Center of USC, 1520 San Pablo St, Ste 2000, Los Angeles, CA, 90033, USA.
Eur Spine J. 2025 Jan;34(1):148-155. doi: 10.1007/s00586-024-08493-2. Epub 2024 Sep 23.
The purpose of this cross-sectional, observational study was to establish the relationship between standing lumbar lordosis (LL) and lateral decubitus LL.
Forty-nine subjects, 24 male and 25 female, were prospectively enrolled. Patients with pre-existing spinopelvic pathology were excluded. Standing, relaxed-seated, and lateral decubitus lateral radiographs were obtained. Radiographic variables measured included LL and lordosis change at each lumbar level (e.g. L1-L2). The change in LL when going from a standing to a lateral decubitus position (ΔLL), the correlation between standing and sitting LL compared to lateral decubitus LL, and the correlation between ΔLL and standing pelvic incidence (PI), pelvic tilt (PT), PI-LL mismatch, pelvic femoral angle (PFA), and sacral slope (SS) were calculated.
Subjects had an average age of 25.7 ± 2.3 years and body mass index of 24.1 ± 3.0 kg/m. On average, 11.9°±8.2° (range - 7° to 29°) of LL was lost when transitioning from a standing to the lateral decubitus position. Lateral decubitus LL had a higher correlation with standing LL (R = 0.725, p < 0.001) than with relaxed-seated LL (R = 0.434, p < 0.001). Standing PT and PI-LL mismatch had moderately negative correlations with ΔLL (R=-0.58 and R=-0.59, respectively, both p < 0.05). Standing PI and standing PFA had a low negative correlation with ΔLL (R=-0.31 and R=-0.44, respectively, both p < 0.05) Standing SS and LL had no correlation with ΔLL.
Standing LL was strongly correlated to lateral decubitus LL, although subjects lost an average of 11.9° from the standing to the lateral decubitus position. This has important implications for fusion in the lateral position.
本横断面观察性研究的目的是建立站立位腰椎前凸（LL）与侧卧位LL之间的关系。
前瞻性纳入49名受试者，其中男性24名，女性25名。排除既往存在脊柱骨盆病变的患者。获取站立位、放松坐位和侧卧位的腰椎侧位X线片。测量的影像学变量包括每个腰椎节段（如L1-L2）的LL和前凸变化。计算从站立位到侧卧位时LL的变化（ΔLL）、站立位和坐位LL与侧卧位LL的相关性，以及ΔLL与站立位骨盆入射角（PI）、骨盆倾斜度（PT）、PI-LL不匹配、骨盆股骨角（PFA）和骶骨坡度（SS）的相关性。
受试者的平均年龄为25.7±2.3岁，体重指数为24.1±3.0kg/m²。从站立位转换到侧卧位时，LL平均减少11.9°±8.2°（范围-7°至29°）。侧卧位LL与站立位LL的相关性（R=0.725，p<0.001）高于与放松坐位LL的相关性（R=0.434，p<0.001）。站立位PT和PI-LL不匹配与ΔLL呈中度负相关（R分别为-0.58和-0.59，均p<0.05）。站立位PI和站立位PFA与ΔLL呈低度负相关（R分别为-0.31和-0.44，均p<0.05）。站立位SS和LL与ΔLL无相关性。
尽管从站立位到侧卧位时受试者的LL平均减少了l1.9°，但站立位LL与侧卧位LL仍密切相关。这对侧方融合具有重要意义。
