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논문 기본 정보

자료유형
학술저널
저자정보
Hey Hwee Weng Dennis (National University Health System Singapore) Ng Nathaniel Li-Wen (Hand and Reconstructive Microsurgery Cluster) Loh Khin Yee Sammy (Yong Loo Lin School of Medicine National University Singapore) Tan Yong Hong (Yong Loo Lin School of Medicine National University Singapore) Tan Kimberly-Anne (National University Health System Singapore) Moorthy Vikaesh (Yong Loo Lin School of Medicine National University Singapore) Lau Eugene Tze Chun (Hand and Reconstructive Microsurgery Cluster National University Health System) Liu Gabriel Ka-Po (National University Health System Singapore) Wong Hee-Kit (Hand and Reconstructive Microsurgery Cluster National University Health System)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.15 No.1
발행연도
2021.1
수록면
23 - 31 (9page)

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Study Design: Prospective radiographic comparative study.Purpose: To compare and understand the load-bearing properties of each functional spinal unit (FSU) using three commonly assumed, physiological, spinal postures, namely, the flexed (slump sitting), erect (standing) and extended (backward bending) postures. Overview of Literature: Sagittal spinal alignment is posture-dependent and influences the load-bearing properties of the spine. The routine placement of intervertebral cages “as anterior as possible” to correct deformity may compromise the load-bearing capabilities of the spine, leading to complications.Methods: We recruited young patients with nonspecific low back pain for <3 months, who were otherwise healthy. Each patient had EOS images taken in the flexed, erect and extended positions, in random order, as well as magnetic resonance imaging to assess for disk degeneration. Angular and disk height measurements were performed and compared in all three postures using paired t-tests. Changes in disk height relative to the erect posture were caclulated to determine the alignment-specific load-bearing area of each FSU.Results: Eighty-three patients (415 lumbar intervertebral disks) were studied. Significant alignment changes were found between all three postures at L1/2, and only between erect and flexion at the other FSUs. Disk height measurements showed that the neutral axis of the spine, marked by zones where disk heights did not change, varied between postures and was level specific. The load-bearing areas were also found to be more anterior in flexion and more posterior in extension, with the erect spine resembling the extended spine to a greater extent.Conclusions: Load-bearing areas of the lumbar spine are sagittal alignment-specific and level-specific. This may imply that, depending on the surgical realignment strategy, attention should be paid not just to placing an intervertebral cage “as anterior as possible” for generating lordosis, but also on optimizing load-bearing in the lumbar spine.
#Lumbar spine #Cage placement #Functional spinal unit #Interbody fusion #Load-bearing

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참고문헌 (28)

참고문헌 신청
Roussouly P / 2005 / Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position / Spine(Phila Pa 1976) 30:346~353 google schola Abitbol MM / 1988 / Effect of posture and locomotion on energy expenditure / Am J Phys Anthropol 77:191~199 google schola Protopsaltis TS / 2015 / How the neck affects the back : changes in regional cervical sagittal alignment correlate to HRQOL improvement in adult thoracolumbar deformity patients at 2-year follow-up / J Neurosurg Spine 23:153~158 google schola Hey HWD / 2017 / Lumbar spine alignment in six common postures : an ROM analysis with implications for deformity correction / Spine(Phila Pa 1976) 42:1447~1455 google schola Hey HW / 2017 / Slump sitting X-ray of the lumbar spine is superior to the conventional flexion view in assessing lumbar spine instability / Spine J 17:360~368 google schola

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