{"title":"不同年龄段胸腰椎的生理旋转模式:使用直立 CT 进行详细分析。","authors":"Ryo Mizukoshi , Mitsuru Yagi , Yoshitake Yamada , Yoichi Yokoyama , Minoru Yamada , Kota Watanabe , Masaya Nakamura , Takeo Nagura , Masahiro Jinzaki","doi":"10.1016/j.gaitpost.2024.10.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The rotational motion of the spine plays a crucial role in daily activities. Understanding the mechanisms of spinal rotation is essential for evaluating normal spinal function, especially in standing positions due to the influence of gravity. However, previous studies on spinal rotation have been limited.</div></div><div><h3>Research Question</h3><div>What are the differences in thoracolumbar rotation during trunk rotation in a standing position among different age and gender groups?</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 49 healthy volunteers without back pain, including 24 younger participants (13 males, 11 females) and 25 elderly participants (12 males, 13 females). Upright and trunk-rotated CT (right-rotated standing positions) scans were taken. Vertebral rotation was measured using the femoral head center as an axis.</div></div><div><h3>Results</h3><div>Analysis of spinal alignment in the standing position revealed mild rotation from the lumbar to thoracic vertebrae. The lumbar spine exhibited left rotation at apex of L3 (L3: −1.3±3.8°, p=0.01), while the lower thoracic spine showed right rotation at apex of T8 (T8: 1.9±2.4°, p<0.001) and the upper thoracic spine showed left rotation at apex of T3 (T3: −2.6±2.9°, p<0.001). The lumbar spine showed minimal rotation during maximum trunk rotation, with significant rotation noted above T10 (16 % vs 84 %). The total thoracolumbar spinal rotation at T1 showed significant differences by gender and age (male vs. female: 23.9±° vs. 30.3±°, p=0.001; young vs. elderly: 29.2±° vs. 25.0±°, p=0.028; elderly male vs. elderly female: 19.2±° vs. 30.4±°, p<0.001). Younger participants did not show significant gender differences, while elderly females retained more rotation compared to males.</div></div><div><h3>Significance</h3><div>This pioneering study provides the first detailed report on the range of spinal rotation in a physiological standing situation, highlighting significant differences by gender and age. These findings offer new insights into the natural patterns of spinal rotation and their potential implications for diagnosing and treating spinal disorders.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"114 ","pages":"Pages 305-312"},"PeriodicalIF":2.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Physiological rotation patterns of the thoracolumbar spine across different ages: A detailed analysis using upright CT\",\"authors\":\"Ryo Mizukoshi , Mitsuru Yagi , Yoshitake Yamada , Yoichi Yokoyama , Minoru Yamada , Kota Watanabe , Masaya Nakamura , Takeo Nagura , Masahiro Jinzaki\",\"doi\":\"10.1016/j.gaitpost.2024.10.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The rotational motion of the spine plays a crucial role in daily activities. Understanding the mechanisms of spinal rotation is essential for evaluating normal spinal function, especially in standing positions due to the influence of gravity. However, previous studies on spinal rotation have been limited.</div></div><div><h3>Research Question</h3><div>What are the differences in thoracolumbar rotation during trunk rotation in a standing position among different age and gender groups?</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 49 healthy volunteers without back pain, including 24 younger participants (13 males, 11 females) and 25 elderly participants (12 males, 13 females). Upright and trunk-rotated CT (right-rotated standing positions) scans were taken. Vertebral rotation was measured using the femoral head center as an axis.</div></div><div><h3>Results</h3><div>Analysis of spinal alignment in the standing position revealed mild rotation from the lumbar to thoracic vertebrae. The lumbar spine exhibited left rotation at apex of L3 (L3: −1.3±3.8°, p=0.01), while the lower thoracic spine showed right rotation at apex of T8 (T8: 1.9±2.4°, p<0.001) and the upper thoracic spine showed left rotation at apex of T3 (T3: −2.6±2.9°, p<0.001). The lumbar spine showed minimal rotation during maximum trunk rotation, with significant rotation noted above T10 (16 % vs 84 %). The total thoracolumbar spinal rotation at T1 showed significant differences by gender and age (male vs. female: 23.9±° vs. 30.3±°, p=0.001; young vs. elderly: 29.2±° vs. 25.0±°, p=0.028; elderly male vs. elderly female: 19.2±° vs. 30.4±°, p<0.001). Younger participants did not show significant gender differences, while elderly females retained more rotation compared to males.</div></div><div><h3>Significance</h3><div>This pioneering study provides the first detailed report on the range of spinal rotation in a physiological standing situation, highlighting significant differences by gender and age. These findings offer new insights into the natural patterns of spinal rotation and their potential implications for diagnosing and treating spinal disorders.</div></div>\",\"PeriodicalId\":12496,\"journal\":{\"name\":\"Gait & posture\",\"volume\":\"114 \",\"pages\":\"Pages 305-312\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gait & posture\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0966636224006325\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gait & posture","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966636224006325","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Physiological rotation patterns of the thoracolumbar spine across different ages: A detailed analysis using upright CT
Background
The rotational motion of the spine plays a crucial role in daily activities. Understanding the mechanisms of spinal rotation is essential for evaluating normal spinal function, especially in standing positions due to the influence of gravity. However, previous studies on spinal rotation have been limited.
Research Question
What are the differences in thoracolumbar rotation during trunk rotation in a standing position among different age and gender groups?
Methods
This cross-sectional study involved 49 healthy volunteers without back pain, including 24 younger participants (13 males, 11 females) and 25 elderly participants (12 males, 13 females). Upright and trunk-rotated CT (right-rotated standing positions) scans were taken. Vertebral rotation was measured using the femoral head center as an axis.
Results
Analysis of spinal alignment in the standing position revealed mild rotation from the lumbar to thoracic vertebrae. The lumbar spine exhibited left rotation at apex of L3 (L3: −1.3±3.8°, p=0.01), while the lower thoracic spine showed right rotation at apex of T8 (T8: 1.9±2.4°, p<0.001) and the upper thoracic spine showed left rotation at apex of T3 (T3: −2.6±2.9°, p<0.001). The lumbar spine showed minimal rotation during maximum trunk rotation, with significant rotation noted above T10 (16 % vs 84 %). The total thoracolumbar spinal rotation at T1 showed significant differences by gender and age (male vs. female: 23.9±° vs. 30.3±°, p=0.001; young vs. elderly: 29.2±° vs. 25.0±°, p=0.028; elderly male vs. elderly female: 19.2±° vs. 30.4±°, p<0.001). Younger participants did not show significant gender differences, while elderly females retained more rotation compared to males.
Significance
This pioneering study provides the first detailed report on the range of spinal rotation in a physiological standing situation, highlighting significant differences by gender and age. These findings offer new insights into the natural patterns of spinal rotation and their potential implications for diagnosing and treating spinal disorders.
期刊介绍:
Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance.
The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.