Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sa...Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sagittal alignment in standing posture in younger generation. Methods: Subjects included 57 females and 32 males (average age, 29.9 ± 5.7 years). All subjects were 20s or 30s. Spinal curvature was assessed using SpinalMouse. The subjects were also divided into a normal group (VAS zero group) and a pain group by VAS results. Statistical analysis was performed by Student’s t-test. Significance was defined as p < 0.05. Results: The normal group and pain group included 29 and 60 subjects, respectively. In terms of location of pain, thirty-one subjects felt neck pain, 50 felt pain above the scapula, and 17 felt pain between the thoracic spine and scapula. Thoracic kyphosis and lumbar lordosis in the pain group were significantly higher than those in the normal group (p = 0.013 and p = 0.020, respectively). Thoracic kyphosis in subjects with neck pain or pain above scapula was significantly higher than that in subjects without pain (p = 0.0075 and p = 0.025, respectively). Lumbar lordosis in subjects with pain above the scapula or interscapula was significantly higher than that in subjects without pain (p = 0.016).展开更多
Purpose: To clarify the effect of percutaneous vertebroplasty for vertebral compression fracture by assessing the changes of radiographic and CT image findings. Materials and Methods: A retrospective radiological anal...Purpose: To clarify the effect of percutaneous vertebroplasty for vertebral compression fracture by assessing the changes of radiographic and CT image findings. Materials and Methods: A retrospective radiological analysis comprising 101 vertebrae of 48 patients who underwent percutaneous vertebroplasty for painful osteoporotic vertebral compression fracture was conducted. Whole spine radiographs and CT images were compared in patients preoperatively and 6 months postoperativey. Sagittal Cobb angles in three regions, sagittal vertical axis, and pelvic tilt were measured using whole spine lateral radiographs. CT findings due to the vertebral compression fracture, its healing process, and complications were evaluated. Results: On radiographs, sagittal alignment had an average gain of no more than 2.5° in each region. Sagittal vertical axis and pelvic tilt did not show significant change. Out of 68 vertebrae that demonstrated cortical disruption on preoperative CT, 37 (54%) demonstrated fusion of disrupted cortex on postoperative CT. Conclusion: No significant difference was observed between preoperative and postoperative spinal sagittal alignment on radiographs. However, CT did reveal healing process through fusion of disrupted cortex, intervertebral bridging, and increased density of cancellous bone. It is suggested that cement in the space of fracture may play a role in both mechanical stability and bone union.展开更多
Background: Recent studies suggest a correlation between spinal sagittal alignment and different types of lumbar pathologies due to different load patterns on the lumbar spine. The main objective of this study was to ...Background: Recent studies suggest a correlation between spinal sagittal alignment and different types of lumbar pathologies due to different load patterns on the lumbar spine. The main objective of this study was to investigate the preoperative spinal sagittal alignment in young patients (Methods: Information regarding preoperative clinical examinations was collected from the patient medical charts. Preoperative MRI examinations were used to classify lumbar types according to four sagittal spinal alignment groups (1: a long thoracic kyphosis, 2: a flat back, 3: a normal spine and 4: an increased thoracic kyphosis). Other MRI findings were also noted. Classification of lumbar types was performed independently by three spine surgeons. To compare two sample proportions the 2-sample z-test was performed. Results: The distribution of lumbar curve types was: Type 1, 17% (9 patients);Type 2, 62% (33 patients);Type 3, 17% (9 patients) and Type 4, 4% (2 patients). The distribution of operated levels was: L3 - L4, 2% (1 patient);L4 - L5, 47% (25 patients);L5 - S1, 42% (22 patients) and L4 - L5 + L5 - S1, 9% (5 patients). Conclusions: A majority of the young patients (62%) that underwent surgery due to herniated disc in the lumbar spine were classified as Type 2 indicating a flat back. Future studies are needed to increase the knowledge about spinopelvic sagittal alignment and the correlation to spinal pathologies.展开更多
目的 ：测量我国中老年人群的脊柱-骨盆矢状位参数并分析其相关性,建立腰椎前凸角与相关脊柱-骨盆矢状位参数的拟合关系。方法：采用影像学测量方法,对106例中老年志愿者进行研究,其中男48例,女58例;年龄62.4±5.2岁（55~76岁）。...目的 ：测量我国中老年人群的脊柱-骨盆矢状位参数并分析其相关性,建立腰椎前凸角与相关脊柱-骨盆矢状位参数的拟合关系。方法：采用影像学测量方法,对106例中老年志愿者进行研究,其中男48例,女58例;年龄62.4±5.2岁（55~76岁）。所有志愿者行全脊柱正、侧位X线摄片,利用院内影像归档与通信系统（picture archiving and communication system,PACS）测量骨盆入射角（pelvic incidence,PI）、骨盆倾斜角（pelvic tilt,PT）、骶骨倾斜角（sacral slope,SS）、腰椎前凸角（lumber lordosis,LL）、上腰弯前凸角（upper arc of total lumbar lordosis,UALL）、下腰弯前凸角（lower arc of total lumbar lordosis,LALL）、胸椎后凸角（thoracic kyphosis,TK）、矢状位平衡（sagittal vertical axis,SVA）等参数,按照脊柱矢状面解剖定义和形态特点分析脊柱-骨盆矢状位形态参数及其相关性,并与青年人群相关参数进行比较,利用线性回归分析建立中老年人群LL与PI、TK的拟合关系。结果 ：我国中老年人群的PI为46.5°±7.6°,PT为13.1°±6.6°,SS为32.3°±9.5°,LL为49.2°±9.1°,UALL为15.9°±5.9°,LALL为32.3°±9.5°,TK为34.0°±10.7°,SVA为-5.0±30mm;LL与SS、TK、PI、PT、SVA呈显著性相关（P〈0.05）,PT与TK、SS呈显著性相关（P〈0.05）,UALL与TK、SVA相关,LALL与PI相关。中老年人群与青年人群比较PI、SS、LL、LALL无显著性差异（P〉0.05）,PT、TK、SVA、UALL有显著性差异（P〈0.01）。中老年人群LL预测值=0.6PI＋0.4TK＋10°,R2=0.375。结论：中老年人群中LL与其他相关脊柱-骨盆各参数之间存在显著相关性,我国中老年人群LL的理想预测值为LL=0.6PI＋0.4TK＋10°;TK、UALL、PT、SVA与青年人群有显著性差异。展开更多
文摘Background: The relationship between chronic neck and shoulder pain and posture remains controversial. The purpose of this study was to investigate the relationship between chronic neck and shoulder pain and spinal sagittal alignment in standing posture in younger generation. Methods: Subjects included 57 females and 32 males (average age, 29.9 ± 5.7 years). All subjects were 20s or 30s. Spinal curvature was assessed using SpinalMouse. The subjects were also divided into a normal group (VAS zero group) and a pain group by VAS results. Statistical analysis was performed by Student’s t-test. Significance was defined as p < 0.05. Results: The normal group and pain group included 29 and 60 subjects, respectively. In terms of location of pain, thirty-one subjects felt neck pain, 50 felt pain above the scapula, and 17 felt pain between the thoracic spine and scapula. Thoracic kyphosis and lumbar lordosis in the pain group were significantly higher than those in the normal group (p = 0.013 and p = 0.020, respectively). Thoracic kyphosis in subjects with neck pain or pain above scapula was significantly higher than that in subjects without pain (p = 0.0075 and p = 0.025, respectively). Lumbar lordosis in subjects with pain above the scapula or interscapula was significantly higher than that in subjects without pain (p = 0.016).
文摘Purpose: To clarify the effect of percutaneous vertebroplasty for vertebral compression fracture by assessing the changes of radiographic and CT image findings. Materials and Methods: A retrospective radiological analysis comprising 101 vertebrae of 48 patients who underwent percutaneous vertebroplasty for painful osteoporotic vertebral compression fracture was conducted. Whole spine radiographs and CT images were compared in patients preoperatively and 6 months postoperativey. Sagittal Cobb angles in three regions, sagittal vertical axis, and pelvic tilt were measured using whole spine lateral radiographs. CT findings due to the vertebral compression fracture, its healing process, and complications were evaluated. Results: On radiographs, sagittal alignment had an average gain of no more than 2.5° in each region. Sagittal vertical axis and pelvic tilt did not show significant change. Out of 68 vertebrae that demonstrated cortical disruption on preoperative CT, 37 (54%) demonstrated fusion of disrupted cortex on postoperative CT. Conclusion: No significant difference was observed between preoperative and postoperative spinal sagittal alignment on radiographs. However, CT did reveal healing process through fusion of disrupted cortex, intervertebral bridging, and increased density of cancellous bone. It is suggested that cement in the space of fracture may play a role in both mechanical stability and bone union.
文摘Background: Recent studies suggest a correlation between spinal sagittal alignment and different types of lumbar pathologies due to different load patterns on the lumbar spine. The main objective of this study was to investigate the preoperative spinal sagittal alignment in young patients (Methods: Information regarding preoperative clinical examinations was collected from the patient medical charts. Preoperative MRI examinations were used to classify lumbar types according to four sagittal spinal alignment groups (1: a long thoracic kyphosis, 2: a flat back, 3: a normal spine and 4: an increased thoracic kyphosis). Other MRI findings were also noted. Classification of lumbar types was performed independently by three spine surgeons. To compare two sample proportions the 2-sample z-test was performed. Results: The distribution of lumbar curve types was: Type 1, 17% (9 patients);Type 2, 62% (33 patients);Type 3, 17% (9 patients) and Type 4, 4% (2 patients). The distribution of operated levels was: L3 - L4, 2% (1 patient);L4 - L5, 47% (25 patients);L5 - S1, 42% (22 patients) and L4 - L5 + L5 - S1, 9% (5 patients). Conclusions: A majority of the young patients (62%) that underwent surgery due to herniated disc in the lumbar spine were classified as Type 2 indicating a flat back. Future studies are needed to increase the knowledge about spinopelvic sagittal alignment and the correlation to spinal pathologies.
文摘目的 ：测量我国中老年人群的脊柱-骨盆矢状位参数并分析其相关性,建立腰椎前凸角与相关脊柱-骨盆矢状位参数的拟合关系。方法：采用影像学测量方法,对106例中老年志愿者进行研究,其中男48例,女58例;年龄62.4±5.2岁（55~76岁）。所有志愿者行全脊柱正、侧位X线摄片,利用院内影像归档与通信系统（picture archiving and communication system,PACS）测量骨盆入射角（pelvic incidence,PI）、骨盆倾斜角（pelvic tilt,PT）、骶骨倾斜角（sacral slope,SS）、腰椎前凸角（lumber lordosis,LL）、上腰弯前凸角（upper arc of total lumbar lordosis,UALL）、下腰弯前凸角（lower arc of total lumbar lordosis,LALL）、胸椎后凸角（thoracic kyphosis,TK）、矢状位平衡（sagittal vertical axis,SVA）等参数,按照脊柱矢状面解剖定义和形态特点分析脊柱-骨盆矢状位形态参数及其相关性,并与青年人群相关参数进行比较,利用线性回归分析建立中老年人群LL与PI、TK的拟合关系。结果 ：我国中老年人群的PI为46.5°±7.6°,PT为13.1°±6.6°,SS为32.3°±9.5°,LL为49.2°±9.1°,UALL为15.9°±5.9°,LALL为32.3°±9.5°,TK为34.0°±10.7°,SVA为-5.0±30mm;LL与SS、TK、PI、PT、SVA呈显著性相关（P〈0.05）,PT与TK、SS呈显著性相关（P〈0.05）,UALL与TK、SVA相关,LALL与PI相关。中老年人群与青年人群比较PI、SS、LL、LALL无显著性差异（P〉0.05）,PT、TK、SVA、UALL有显著性差异（P〈0.01）。中老年人群LL预测值=0.6PI＋0.4TK＋10°,R2=0.375。结论：中老年人群中LL与其他相关脊柱-骨盆各参数之间存在显著相关性,我国中老年人群LL的理想预测值为LL=0.6PI＋0.4TK＋10°;TK、UALL、PT、SVA与青年人群有显著性差异。
