Changes in the global spine alignment in the sitting position in an automobile
Changes in the global spine alignment in the sitting position in an automobile
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DOI：
10.1016/j.spinee.2019.11.016
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发表时间：
2020-04-01
期刊：
影响因子：
4.5
通讯作者：
Sakai, Takashi
中科院分区：
文献类型：
--
作者：
Nishida, Norihiro;Izumiyama, Tomohiro;Sakai, Takashi
背景：关于坐位脊柱排列变化的研究仅限于特定的脊柱节段。由于很少有关于坐姿时脊柱-骨盆整体排列的研究，因此评估与坐姿相关的变化对于开发未来座椅设计和实现脊柱排列的适当恢复等设置非常重要。目的：本研究旨在测量人们坐在汽车座椅中时脊柱整体排列的变化，并分析这些变化的特征。这是一项前瞻性的协作研究，对脊柱整体排列的变化进行放射学评价。患者样本：该研究包括113名无症状的成年受试者（56名男性和57名女性）没有脊柱疾病或下肢手术史，并且没有当前的下背部或腿部疼痛。颈椎前凸（CL）、胸椎后凸（TK）、胸腰椎后凸（TLK）、腰椎前凸（LL）、骶骨倾斜度（SS）、骨盆倾斜度（PT）、骨盆倾斜度（PI）、C7矢状垂直轴（C7 SVA）、T1脊柱骨盆倾斜度（T1 SPI）和T1骨盆角（TPA）。统计学分析的客观变量是脊柱对线（CL、TK、TLK、LL、C7-SVA、T1 SPI、TPA、SS、PT和PI）在站立位、身体对齐时测量（CL、TK、TLK、LL、C7-SVA、T1 SPI、TPA、SS和PT）在坐位和站-坐变化中测量（Delta CL、Delta TK、Delta TLK、Delta LL、Delta C7-SVA、Delta T1SPI、Delta TPA、Delta SS和Delta PT）。解释变量为性别、年龄、身高和体重指数。从站立到坐姿的改变使CL平均降低5.3度，TK平均略微降低1.3度，TLK平均增加6.8度，LL平均降低35度，SS平均降低49.2度，PT平均增加49.2度，C7 SVA平均向后移动106.7 mm，T1 SPI平均降低18.8度，TPA平均增加21.1度。统计分析显示，老年参与者的Delta LL显著降低。后站到坐的变化，三角洲TLK和三角洲TPA显着增加，在较高的参与者和三角洲T1 SPI显着降低在taller participants.CONCLUSIONS：在其他变化中，最显着的LL是减少和骨盆倾斜增加时，一个人坐在汽车座椅。然而，这些脊柱排列的变化随年龄和身高而不同。这些发现可能有助于未来座椅设计的发展，并实现适当的手术恢复脊柱对线。(C)2019爱思唯尔公司All rights reserved.
BACKGROUND CONTEXT: Studies of the changes in spine alignment in the sitting position have been limited to specific spine segments. Because there have been few studies of global spino-pelvic alignment in the sitting position, it is important to assess the changes associated with this position for such settings as developing future design of seats and achieving appropriate restoration of spine alignment.PURPOSE: This study aimed to measure changes in global spine alignment when people are sitting in car seats and to analyze the characteristics of those changes.STUDY DESIGN: This was a prospective, collaborative study of the radiological evaluation of changes in global spine alignment.PATIENT SAMPLE: The study included 113 asymptomatic adult participants (56 men and 57 women) without a history of spine disease or lower limb surgery, and with no current lower back or leg pain.OUTCOME MEASURES: Radiographic findings were assessed by measurement of various angles: cervical lordosis (CL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), C7 sagittal vertical axis (C7SVA), T1 spinopelvic inclination (T1SPI), and T1 pelvic angle (TPA).METHODS: Radiographs were obtained in the standing and sitting positions. The objective variables analyzed statistically were spine alignments (CL, TK, TLK, LL, C7-SVA, T1SPI, TPA, SS, PT, and PI) measured in the standing position, body alignments (CL, TK, TLK, LL, C7-SVA, T1SPI, TPA, SS, and PT) measured in the sitting position, and stand-to-sit changes (Delta CL, Delta TK, Delta TLK, Delta LL, Delta C7-SVA, Delta T1SPI, Delta TPA, Delta SS, and Delta PT). Explanatory variables were sex, age, body height, and body mass index.RESULTS: Changing posture from standing to sitting decreased CL by an average of 5.3 degrees, slightly decreased TK by an average of 1.3 degrees, increased TLK by an average of 6.8 degrees, decreased LL by an average of 35 degrees, decreased SS by an average of 49.2 degrees, increased PT by an average of 49.2 degrees, shifted C7SVA backward by an average of 106.7 mm, decreased T1SPI by an average of 18.8 degrees, and increased TPA by an average of 21.1 degrees. Statistical analysis revealed that Delta LL was significantly decreased in elderly participants. After the stand-to-sit change, Delta TLK and Delta TPA were significantly increased in taller participants and Delta T1SPI was significantly decreased in taller participants.CONCLUSIONS: Among other changes, most notably LL is decreased and the pelvic tilt is increased when a person is sitting in a car seat. However, these changes in spine alignment differ with age and height. These findings may be useful for the development of future design of seats and for achieving appropriate surgical restoration of spine alignment. (C) 2019 Elsevier Inc. All rights reserved.