Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model.
Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model.
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在使用三维肌肉骨骼模型站立和行走时，评估具有骨盆追溯的老年妇女的矢状脊柱脊柱较低的肢体对准。
DOI：
10.4184/asj.2017.11.4.562
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发表时间：
2017-08
影响因子：
2.3
通讯作者：
Shimada Y
中科院分区：
文献类型：
--
作者：
Sasaki K;Hongo M;Miyakoshi N;Matsunaga T;Yamada S;Kijima H;Shimada Y
使用三维（3D）肌肉骨骼模型对有或无骨盆后倾的老年人进行体内生物力学研究。评价老年女性站立和行走时骨盆后倾对脊柱、骨盆和下肢矢状面排列的影响。髋脊柱综合征患者同时患有髋关节和脊柱疾病。然而，髋关节和脊柱之间的动态矢状面对准很少被研究。我们使用三维肌肉骨骼模型来评估整体脊柱骨盆参数，包括脊柱倾斜度和骨盆倾斜度（PT）。共有32名无辅助的非卧床女性（平均年龄=78岁）入组本研究。根据PT的X线测量结果，将受试者分为骨盆后倾组（R组; PT≥20°）和正常组（N组; PT<20°）。使用3D肌肉骨骼运动分析系统分析脊柱、骨盆和下肢对线的计算值，包括计算的（C）-PT、矢状垂直轴（C-SVA）、骨盆发生率、腰椎前凸、T1骨盆角（C-TPA）以及站立和行走时的膝关节和髋关节屈曲角。站立时，R组C-PT和C-TPA显著大于N组。与膝关节角度不同，R组的髋关节角度显著小于N组，而膝关节角度没有显示出差异。步行时C-SVA、C-TPA较站立时明显升高，C-PT较站立时明显降低。R组的最大髋关节屈曲角显著小于N组。有一个显着的相关性之间的放射学和计算参数。3D肌肉骨骼模型可用于评估脊柱、骨盆和腿部的矢状面对齐。行走时脊柱骨盆矢状面排列出现恶化。在R组中，C-PT在行走时显著降低，表明可能的代偿机制试图增加股骨头的覆盖。R组髋关节屈曲角度的减小也被认为是一种代偿机制。
In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. Patients with hip–spine syndrome have concurrent hip-joint and spine diseases. However, the dynamic sagittal alignment between the hip joint and spine has rarely been investigated. We used a 3D musculoskeletal model to evaluate global spinopelvic parameters, including spinal inclination and pelvic tilt (PT). A total of 32 ambulant females (mean age=78 years) without assistance were enrolled in the study. On the basis of the radiographic measurement for PT, participants were divided into the pelvic retroversion group (R-group; PT≥20°) and the normal group (N-group; PT<20°). A 3D musculoskeletal motion analysis system was used to analyze the calculated value for the alignment of spine, pelvis, and lower limb, including calculated (C)-PT, sagittal vertical axis (C-SVA), pelvic incidence, lumbar lordosis, T1 pelvic angle (C-TPA), as well as knee and hip flexion angles while standing and walking. While standing, C-PT and C-TPA in the R-group were significantly larger than those in the N-group. Hip angle was significantly smaller in the R-group than in the N-group, unlike knee angle, which did not show difference. While walking, C-SVA and C-TPA were significantly increased, whereas C-PT decreased compared with those while standing. The maximum hip-flexion angle was significantly smaller in the R-group than in the N-group. There was a significant correlation between the radiographic and calculated parameters. The 3D musculoskeletal model was useful in evaluating the sagittal alignment of the spine, pelvis, and leg. Spinopelvic sagittal alignment showed deterioration while walking. C-PT was significantly decreased while walking in the R-group, indicating possible compensatory mechanisms attempting to increase coverage of the femoral head. The reduction in the hip flexion angle in the R-group was also considered as a compensatory mechanism.