PDF(Pubmed)
Abstract：
UNASSIGNED: In upright standing, spinopelvic mismatch is compensated by hip extension. However, few studies have investigated the reciprocal relationship between the sagittal alignment of the hip joints and spinopelvic mismatch during upright standing in humans. Our study aims to investigate (I) the relationship between spinopelvic mismatch and hip extension and (II) whether insufficient hip extension against spinopelvic mismatch, i.e., pelvic incidence (PI)-lumbar lordosis (LL), affects trunk inclination in upright standing.
UNASSIGNED: This study was a retrospective cross-sectional study. We included 398 consecutive female patients treated for osteoporosis at our outpatient department between November 2017 and June 2022. Patients with any of the following were excluded from the study: (I) those whose plain whole-spine radiographs did not cover the femurs, (II) those with fractures in the vertebrae or lower extremities, (III) those with a history of surgery of the spine or of the lower extremities, (IV) those with scoliosis with a Cobb angle ≥10° in the anteroposterior radiograph, and (V) those with transitional vertebrae. Sixty-two patients were divided into normal and malalignment groups based on their sagittal spinal alignment. The patients underwent plain whole-spine radiography as a routine examination. A linear approximation between the pelvic femoral angle (PFA), representing hip extension, and PI-LL was obtained in both groups. The optimal PFA of each patient was obtained by substituting the PI-LL into the linear approximation of the normal group. The difference between the optimal and measured PFA was defined as the ΔPFA for each patient. The correlation between the ΔPFA and sagittal vertical axis (SVA) was evaluated in both groups.
UNASSIGNED: The PFA and PI-LL were correlated in both groups. The malalignment group had a significantly greater ΔPFA than the normal group. ΔPFA was correlated with SVA only in the malalignment group.
UNASSIGNED: The magnitude of the ΔPFA indicated insufficient hip extension to compensate for the spinopelvic mismatch during upright standing.
UNASSIGNED: This study was a retrospective cross-sectional study. We included 398 consecutive female patients treated for osteoporosis at our outpatient department between November 2017 and June 2022. Patients with any of the following were excluded from the study: (I) those whose plain whole-spine radiographs did not cover the femurs, (II) those with fractures in the vertebrae or lower extremities, (III) those with a history of surgery of the spine or of the lower extremities, (IV) those with scoliosis with a Cobb angle ≥10° in the anteroposterior radiograph, and (V) those with transitional vertebrae. Sixty-two patients were divided into normal and malalignment groups based on their sagittal spinal alignment. The patients underwent plain whole-spine radiography as a routine examination. A linear approximation between the pelvic femoral angle (PFA), representing hip extension, and PI-LL was obtained in both groups. The optimal PFA of each patient was obtained by substituting the PI-LL into the linear approximation of the normal group. The difference between the optimal and measured PFA was defined as the ΔPFA for each patient. The correlation between the ΔPFA and sagittal vertical axis (SVA) was evaluated in both groups.
UNASSIGNED: The PFA and PI-LL were correlated in both groups. The malalignment group had a significantly greater ΔPFA than the normal group. ΔPFA was correlated with SVA only in the malalignment group.
UNASSIGNED: The magnitude of the ΔPFA indicated insufficient hip extension to compensate for the spinopelvic mismatch during upright standing.
摘要：
■直立站立，脊柱骨盆不匹配是由髋关节延伸补偿。然而,很少有研究调查了直立站立过程中髋关节矢状排列与脊柱骨盆不匹配之间的相互关系。我们的研究旨在调查（I）脊柱骨盆不匹配与髋关节伸展之间的关系，以及（II）髋关节伸展不足是否针对脊柱骨盆不匹配，即，骨盆发病率（PI）-腰椎前凸（LL），影响直立时的躯干倾斜度。
■本研究为回顾性横断面研究。我们纳入了2017年11月至2022年6月在我们的门诊接受骨质疏松症治疗的398名连续女性患者。有以下任何一项的患者被排除在研究之外：（I）那些全脊柱平片没有覆盖股骨的患者，（II）椎骨或下肢骨折的人，（三）有脊柱或下肢手术史的人，(四)脊柱侧凸前后X线片Cobb角≥10°者,和（V）具有过渡椎骨的那些。根据矢状脊柱排列将62例患者分为正常组和错位组。患者接受了全脊柱平片作为常规检查。骨盆股骨角度（PFA）之间的线性近似，代表臀部伸展，两组均获得PI-LL。通过将PI-LL代入正常组的线性近似，获得每位患者的最佳PFA。最佳和测量的PFA之间的差异定义为每个患者的ΔPFA。在两组中评估了ΔPFA与矢状垂直轴（SVA）之间的相关性。
■两组PFA和PI-LL均相关。不对准组的ΔPFA明显高于正常组。仅在不对齐组中，ΔPFA与SVA相关。
■ΔPFA的大小表明髋部伸展不足以补偿直立站立时的脊柱骨盆不匹配。
■本研究为回顾性横断面研究。我们纳入了2017年11月至2022年6月在我们的门诊接受骨质疏松症治疗的398名连续女性患者。有以下任何一项的患者被排除在研究之外：（I）那些全脊柱平片没有覆盖股骨的患者，（II）椎骨或下肢骨折的人，（三）有脊柱或下肢手术史的人，(四)脊柱侧凸前后X线片Cobb角≥10°者,和（V）具有过渡椎骨的那些。根据矢状脊柱排列将62例患者分为正常组和错位组。患者接受了全脊柱平片作为常规检查。骨盆股骨角度（PFA）之间的线性近似，代表臀部伸展，两组均获得PI-LL。通过将PI-LL代入正常组的线性近似，获得每位患者的最佳PFA。最佳和测量的PFA之间的差异定义为每个患者的ΔPFA。在两组中评估了ΔPFA与矢状垂直轴（SVA）之间的相关性。
■两组PFA和PI-LL均相关。不对准组的ΔPFA明显高于正常组。仅在不对齐组中，ΔPFA与SVA相关。
■ΔPFA的大小表明髋部伸展不足以补偿直立站立时的脊柱骨盆不匹配。
