The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study.
The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study.
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青少年特发性脊柱侧弯的腰曲线幅度和脊柱运动范围的关联：一项横断面研究。
DOI：
10.1186/s12891-017-1423-6
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发表时间：
2017-01-31
影响因子：
2.3
通讯作者：
Cheung JP
中科院分区：
文献类型：
--
作者：
Eyvazov K;Samartzis D;Cheung JP
脊柱畸形会影响脊柱的整体对齐，从而影响腰椎区域和椎间盘上的负荷矢量。由于不平衡的脊柱节段的椎间盘或椎体楔入，对齐改变可能会影响单个脊柱节段或整体脊柱的活动范围(ROM)。这在青少年特发性脊柱侧凸(AIS)患者中尤其重要，他们可能患有早期退行性变、背部僵硬和疼痛。因此，本研究旨在确定脊柱活动度(ROM)与青少年特发性脊柱侧凸(AIS)曲度大小的相关性。对所有有Lenke5(胸腰椎/腰椎)曲度的AIS患者在1个月内进行连续招募，在冠状面、矢状面和枢轴面进行关节活动度评估，包括直立时C7-S1距离的变化、主动屈曲和伸展位置C7-S1距离的变化、前屈位和侧弯时指底距离的变化、侧弯角度、改良的肖伯氏试验和坐位躯干旋转。根据腰椎曲度的大小，患者被进一步分为两组：A组曲度在10度到39度之间，B组曲度在40度或更高。以腰椎曲度严重程度为因变量进行了单变量和多变量分析。总共招募了58名患者(n = 男性12例，n = 女性46例；平均年龄：15.7岁)。平均曲度A组为25 ± 6.5°，B组为48 ± 10.6°；平均轴向旋转(A组：90 ± 21.7°；B组：76 ± 19.6°；p = 0.038)和侧弯活动度(A组：67 ± 13.4°；B组：58 ± 14.3°；p = 0.045)。无论曲线严重程度的分界值如何，这两个参数仍然显著。这是第一次确定脊柱活动度参数与AIS患者腰椎曲度大小之间的关系的研究。我们发现，冠状曲线的严重程度与轴位和冠状位的活动度降低有关。这是一个未来研究的平台，用于评估AIS患者的腰椎生物力学，并确定在这种情况下改变脊柱运动的影响及其对患者管理和预后的影响。
Spinal deformities affect the overall alignment of the spine and thus the vectors of loading on the lumbar region and intervertebral discs. Due to wedging of the disc or vertebrae of unbalanced spinal segments, alignment change may affect the range of motion (ROM) of individual spinal segments or the global spine. This is particularly important in adolescent idiopathic scoliosis (AIS) patients who may suffer from early degeneration, back stiffness and pain. Hence, this study aimed to determine the correlation between spine range of motion (ROM) and adolescent idiopathic scoliosis (AIS) curve magnitude. Consecutive recruitment of all AIS patients with Lenke 5 (thoracolumbar/lumbar) curves within one month was performed with ROM assessments in the coronal, sagittal and axial planes using the change in C7-S1 distance on standing upright, active flexion and extension positions, change in finger-floor distance on forward bending position and lateral bending, lateral bending angles, modified Schober’s test, and trunk rotation in seating position. Patients were further stratified into two groups based on their lumbar spine curve magnitude: Group A with curves of 10 to 39 degrees and Group B with 40 degrees or greater. Univariate and multivariate analyses were conducted, with lumbar curve magnitude severity being the dependent variable. In total, 58 patients (n = 12 males, n = 46 females; mean age: 15.7 years) were recruited. The mean curve magnitudes were 25 ± 6.5 degrees in Group A and 48 ± 10.6 degrees in Group B. Mean axial rotation (Group A: 90 ± 21.7 degree; Group B: 76 ± 19.6 degrees; p = 0.038) and lateral bending ROM (Group A: 67 ± 13.4 degrees; Group B: 58 ± 14.3 degrees; p = 0.045) decreased in more severe curves. These two parameters continued to remain significant irrespective of the curve severity cut-off values. This is the first study to determine associations between spinal ROM parameters with the lumbar curve magnitude in AIS patients. We found that the coronal curve severity is associated with reduced axial and coronal ROM. This is a platform for future studies assessing lumbar spine biomechanics in AIS and to determine the effects of altered spine motion in this context and its implication in patient management and outcomes.