Physiological rotation patterns of the thoracolumbar spine across different ages: A detailed analysis using upright CT

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2024-10-01 DOI:10.1016/j.gaitpost.2024.10.005

Ryo Mizukoshi , Mitsuru Yagi , Yoshitake Yamada , Yoichi Yokoyama , Minoru Yamada , Kota Watanabe , Masaya Nakamura , Takeo Nagura , Masahiro Jinzaki

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Abstract

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.

查看原文本刊更多论文

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。

背景：脊柱的旋转运动在日常活动中起着至关重要的作用。了解脊柱旋转的机制对于评估正常的脊柱功能至关重要，尤其是在受重力影响的站立姿势下。然而，以往有关脊柱旋转的研究非常有限：研究问题：在站立姿势下旋转躯干时，不同年龄和性别群体的胸腰椎旋转有何差异？这项横断面研究涉及 49 名无背痛的健康志愿者，包括 24 名年轻参与者（13 名男性，11 名女性）和 25 名老年参与者（12 名男性，13 名女性）。研究人员进行了直立和躯干旋转 CT（右旋站立位）扫描。以股骨头中心为轴测量椎体旋转：结果：对站立姿势下脊柱排列的分析表明，从腰椎到胸椎都有轻度旋转。腰椎在 L3 顶点处显示左旋（L3：-1.3±3.8°，p=0.01），而下胸椎在 T8 顶点处显示右旋（T8：1.9±2.4°，p意义重大：这项开创性的研究首次详细报告了生理站立情况下脊柱旋转的范围，突出显示了不同性别和年龄的显著差异。这些发现为脊柱旋转的自然模式及其对诊断和治疗脊柱疾病的潜在影响提供了新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

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.