The effect of variation in arm position on sagittal spinal alignment
The effect of variation in arm position on sagittal spinal alignment
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DOI：
10.1097/00007632-200009010-00011
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发表时间：
2000-09-01
期刊：
影响因子：
3
通讯作者：
Blanke, K
中科院分区：
文献类型：
--
作者：
Vedantam, R;Lenke, LG;Blanke, K
研究设计。有无脊柱融合者矢状面排列的前瞻性放射学分析。目的：评价臂位变化对节段性、区域性和全身性脊柱矢状位的影响。此外，为了确定脊柱融合是否对手臂位置变化对脊柱矢状面对齐的影响有任何影响。节段性、区域性和全局性矢状位排列的重要性已得到广泛推广。然而，在脊柱侧位X线片中，并没有提到手臂的定位以及由此可能对矢状位和平衡产生的影响。对40例有脊柱融合史和40例无脊柱融合史的患者进行了前瞻性评估。对患者进行标准化的长盒式侧位X线片，第一张X光片是在肩部屈曲90度时双臂水平向前抬起，第二张X光片是在肩部屈曲30度时双臂水平向前抬起。对标准的节段性、区域性和全局性矢状位进行测量，并进行统计学比较。比较第1组(脊柱融合者)和第2组(非融合者)，节段性和区域性矢状位排列无统计学差异。然而，将手臂放置在90度和30度时，患者的矢状面垂直轴负移，在有脊柱融合史的患者中有统计学意义(P=0.038)(90度时为-6 mm，30度时为+4 mm)，而在未融合的患者中(90度时为-8 mm，30度时为-4 mm)，差异无统计学意义(P=0.119)。根据这项研究的发现，作者建议在拍摄整个脊柱的长卡式侧位片时，将手臂从垂直方向前屈30度。
Study Design. A prospective radiographic analysis of sagittal alignment in patients with and without previous spinal fusion.Objectives. To evaluate the effect of variation of arm position on the segmental, regional, and global sagittal radiographic spinal alignment. In addition, to determine whether spinal fusion has any influence on the effect of variation in arm position on the sagittal spinal alignment.Summary of Background Data. Importance of segmental, regional, and global sagittal alignment has been widely promoted. However, no mention has been made of arm positioning during a lateral spinal radiograph and the resultant effects it may have on sagittal alignment and balance.Methods. Prospective evaluation of 40 consecutive patients with and 40 consecutive patients without a previous spinal fusion was performed. The patients had lateral long cassette radiographs performed in a standardized fashion with the first radiograph obtained with the patient's arms raised horizontally forward at 90 degrees of flexion at the shoulder, and the second radiograph obtained with arms raised horizontally forward at 30 degrees of flexion at the shoulder. Standard segmental, regional, and global sagittal alignments were measured and statistically compared.Results. In comparing group 1 (patients with spinal fusion) to group 2 (patients without spinal fusion), there was no statistically significant difference in segmental and regional sagittal alignments. However, positioning the arms at 90 degrees versus 30 degrees resulted in a negative shift of the sagittal vertical axis (SVA) in patients that was statistically significant (P = 0.038) for those with (-6 mm at 90 degrees vs +4 mm at 30 degrees), but not (P = 0.119) for those patients without (-8 mm at 90 degrees vs -4 mm at 30 degrees) a previous spinal fusion.Conclusions. Based on the findings in this study, the authors recommend positioning the arms at 30 degrees of forward flexion from the vertical when obtaining a long cassette lateral radiograph of the entire spine.