4.5 Article

In vivo segmental vertebral kinematics in patients with degenerative lumbar scoliosis

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EUROPEAN SPINE JOURNAL
卷 -, 期 -, 页码 -

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SPRINGER
DOI: 10.1007/s00586-023-07974-0

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Degenerative lumbar scoliosis; Kinematics; In vivo; Coupled pattern; Range of motion

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This study aimed to find a standard of vertebral kinematics during functional weight-bearing activities in degenerative lumbar scoliosis (DLS) patients. The study found that the greatest coupled translation occurred at L5-S1 in DLS patients. The coupled anteroposterior (AP) and mediolateral (ML) translations at L5-S1 were higher in these patients compared to healthy participants.
Purpose This study aimed to find a standard of the vertebra kinematics during functional weight-bearing activities in degenerative lumbar scoliosis (DLS) patients.Methods Fifty-four patients were involved into this study with forty-two in DLS group and twelve in the control group. The three-dimensional (3D) vertebral models from L1 to S1 of each participant were reconstructed by computed tomography (CT). Dual-orthogonal fluoroscopic imaging, along with FluoMotion and Rhinoceros software, was used to record segmental vertebral kinematics during functional weight-bearing activities. The primary and coupled motions of each vertebra were analyzed in patients with DLS.Results During flexion-extension of the trunk, anteroposterior (AP) translation and craniocaudal (CC) translation at L5-S1 were higher than those at L2-3 (9.3 +/- 5.1 mm vs. 6.4 +/- 3.5 mm; P < 0.05). The coupled mediolateral (ML) translation at L5-S1 in patients with DLS was approximately three times greater than that in the control group. During left-right bending of the trunk, the coupled ML rotation at L5-S1 was higher in patients with DLS than that in the control group (17.7 +/- 10.3 degrees vs. 8.4 +/- 4.4 degrees; P < 0.05). The AP and CC translations at L5-S1 were higher than those at L1-2, L2-3, and L3-4. During left-right torsion of the trunk, the AP translation at L5-S1 was higher as compared to other levels.Conclusions The greatest coupled translation was observed at L5-S1 in patients with DLS. Coupled AP and ML translations at L5-S1 were higher than those in healthy participants. These data improved the understanding of DLS motion characteristics.

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