CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, 21000, France.
INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, Dijon, 21000, France.
BMC Musculoskelet Disord. 2024 Oct 19;25(1):827. doi: 10.1186/s12891-024-07923-y.
Sagittal balance, commonly impaired in lumbar spinal stenosis (LSS) patients, is typically assessed using the sagittal vertical axis (SVA) with EOS imaging. However, to limit X-ray exposure and medical costs, it could be interesting to evaluate the capacity of quantified motion analysis to estimate the 3D modeling of SVA in patients with symptomatic LSS.
An estimation of the SVA in patients with LSS was performed with 3D motion analysis. SVA and "C7_PSI" (orthogonal horizontal distance between the vertical lines through the markers of the C7 vertebra and the middle of the posterosuperior iliac spine) were measured on 37 LSS patients using EOS radiography and postural and 3D motion analysis, respectively. Multiple stepwise linear regressions were performed with EOS SVA according to age, body mass index, C7_PSI and/or postural variables.
A highly significant relationship was found between SVA and C7_PSI, mediolateral amplitude of CoP displacements and age (adjusted R²=0.69, p < 0.0001). While the postural analysis did not reveal significant relationships, the model using 3D parameters revealed significant relationships between radiographic SVA and C7_PSI and age (adjusted R²=0.65, p < 0.0001). 3D motion parameters with or without postural parameters may explain more than 65% of the variance seen in EOS imaging performed on LSS patients.
These promising results in LSS patients suggest that the estimation of SVA with 3D motion analysis offers an alternative to EOS. In addition, SVA could be assessed at rest and during dynamic tasks.
This study has been published in Clinical Trial registration (reference NCT03194607).
腰椎管狭窄症（LSS）患者常存在矢状位平衡障碍，通常使用 EOS 成像评估矢状垂直轴（SVA）。然而，为了限制 X 射线暴露和医疗费用，评估量化运动分析对估计有症状的 LSS 患者 SVA 的 3D 建模的能力可能很有趣。
使用 3D 运动分析对 LSS 患者的 SVA 进行评估。通过 EOS 射线照相术和姿势以及 3D 运动分析，分别在 37 例 LSS 患者中测量 SVA 和“C7_PSI”（C7 椎体标记物与后上髂嵴中点之间的正交水平距离）。根据年龄、体重指数、C7_PSI 和/或姿势变量，对 EOS SVA 进行多元逐步线性回归。
发现 SVA 与 C7_PSI、CoP 位移的横移幅度和年龄之间存在高度显著的关系（调整后的 R²=0.69，p<0.0001）。虽然姿势分析没有发现显著关系，但使用 3D 参数的模型显示，放射学 SVA 与 C7_PSI 和年龄之间存在显著关系（调整后的 R²=0.65，p<0.0001）。具有或不具有姿势参数的 3D 运动参数可以解释 LSS 患者在 EOS 成像中观察到的超过 65%的方差。
这些在 LSS 患者中的有希望的结果表明，使用 3D 运动分析评估 SVA 提供了 EOS 的替代方案。此外，SVA 可以在休息和动态任务时进行评估。
本研究已在临床试验注册（参考 NCT03194607）中发表。
