Background： Thoracolumbar junction （TLJ） is the transitional area between the lower thoracic spine and the upper lumbar spine. Vertebral compression fractures and proximal junctional kyphosis following spine surger...Background： Thoracolumbar junction （TLJ） is the transitional area between the lower thoracic spine and the upper lumbar spine. Vertebral compression fractures and proximal junctional kyphosis following spine surgery often occur in this area. Therefore, the study of development and mechanisms of thoracolumbar junctional degeneration is important for planning surgical management. This study aimed to review radiological parameters of thoracolumbar junctional degenerative kyphosis （TLJDK） in patients with lumbar degenerative kyphosis and to analyze compensatory mechanisms of sagittal balance. Methods： From January 2016 to March 2017, patients with lumbar degenerative kyphosis were enrolled in this radiographic study. Patients were divided into two groups according to thoracolumbar junctional angle （TLJA）： the non-TLJDK （NTLJDK） group （TLJA 〈10°） and the TLJDK group （TLJA≥10°）. Complete spinopelvic radiographic parameters were analyzed and compared between two groups. Pearson or Spearman correlation coefficients and independent two-sample t-test or Mann-Whitney U-test were used. Results： Atotal of 77 patients with symptomatic sagittal imbalance due to lumbar degenerative kyphosis were enrolled in this study. There were 34 patients in NTLJDK group （TLJA 〈10°） and 43 patients in TLJDK group （TLJA ≥10°）. The median angle of lumbar lordosis （LL） in the NTLJDK or TLJDK groups was 23.40° （18.50°, 29.48°） or 19.50° （13.30°, 24.55°）, respectively. The median TLJAs in all patients and both groups were -11.20° （-14.60°, -4.80°）, -3.70° （-7.53°, -1.73°）, and -14.30° （-17.45°, -13.00°）, respectively. In the NTLJDK group, LLwas correlated with thoracic kyphosis （TK; r = -0.400, P = 0.019）, sacral slope （SS; r = 0.681, P 〈 0.001）, and C7-sagittal vertical axis （r = -0.402, P = 0.018）. In the TLJDK group, LL was correlated with TK （r = -0.345, P = 0.024）, SS （r = 0.595, P 〈 0.001）, and pelvic tilt （r = -0.363, P = 0.0展开更多
目的系统评价运动干预对成人胸椎后凸畸形患者的影响。方法计算机检索PubMed、EMbase、Web of Science、CINAHL、Cochrane Library、CNKI、CBM、WanFang Data和VIP数据库,搜集与研究目的相关的随机对照试验(RCT),检索时限均为建库至2022...目的系统评价运动干预对成人胸椎后凸畸形患者的影响。方法计算机检索PubMed、EMbase、Web of Science、CINAHL、Cochrane Library、CNKI、CBM、WanFang Data和VIP数据库,搜集与研究目的相关的随机对照试验(RCT),检索时限均为建库至2022年11月。2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入10个RCT,包括482例患者。Meta分析结果显示,与对照组相比,运动干预能够有效减少胸椎后凸角度[MD=-5.27,95%CI(-8.37,-2.17),P<0.01],提高患者生活质量[SMD=0.78,95%CI(0.52,1.04),P<0.01],但对疼痛和身体功能无显著影响。结论当前证据显示,运动干预能够改善成人胸椎畸形患者的胸椎后凸角度和生活质量,但对疼痛和身体功能的影响尚不明确。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。展开更多
Purpose:This study investigated the effects of obesity on breast size,thoracic spine structure and function,upper torso musculoskeletal pain and physical activity participation in women living independently in the com...Purpose:This study investigated the effects of obesity on breast size,thoracic spine structure and function,upper torso musculoskeletal pain and physical activity participation in women living independently in the community.Methods:A total of 378 women were divided into 3 groups(Not Overweight:body mass index(BMI)=22.5±0.2 kg/m^2(mean±SE);Overweight:BMI=27.4±0.3 kg/m^2;Obese:BMI=35.4±0.3 kg/m^2).Outcome variables of breast volume(mL),thoracic flexion torque(N·m),thoracic kyphosis(degrees),upper torso musculoskeletal pain(score) and time spent in physical activity(min) were calculated and compared among the 3 groups,adjusting for between-group differences in age.Results:There was a significant main effect of BMI on all outcome variables.Participants classified as Obese displayed significantly larger breasts,had greater thoracic flexion torques and reported less time participating in physical activity relative to the participants who were classified as Not Overweight and Overweight.Participants in the Obese group also displayed significantly more thoracic kyphosis and reported significantly more upper torso musculoskeletal pain compared to their counterparts who were classified as Not Overweight.Conclusion:This study is the first to demonstrate that increased obesity levels were associated with compromised kyphosis and loading of the thoracic spine,as well as increased symptoms of upper torso musculoskeletal pain and reduced time spent in physical activity in women living in the community.We recommend further research to determine whether evidence-based interventions designed to reduce the flexion torque generated on the thoracic spine can improve these symptoms of upper torso musculoskeletal pain and the ability of women with obesity to participate in physical activity.展开更多
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
文摘Background： Thoracolumbar junction （TLJ） is the transitional area between the lower thoracic spine and the upper lumbar spine. Vertebral compression fractures and proximal junctional kyphosis following spine surgery often occur in this area. Therefore, the study of development and mechanisms of thoracolumbar junctional degeneration is important for planning surgical management. This study aimed to review radiological parameters of thoracolumbar junctional degenerative kyphosis （TLJDK） in patients with lumbar degenerative kyphosis and to analyze compensatory mechanisms of sagittal balance. Methods： From January 2016 to March 2017, patients with lumbar degenerative kyphosis were enrolled in this radiographic study. Patients were divided into two groups according to thoracolumbar junctional angle （TLJA）： the non-TLJDK （NTLJDK） group （TLJA 〈10°） and the TLJDK group （TLJA≥10°）. Complete spinopelvic radiographic parameters were analyzed and compared between two groups. Pearson or Spearman correlation coefficients and independent two-sample t-test or Mann-Whitney U-test were used. Results： Atotal of 77 patients with symptomatic sagittal imbalance due to lumbar degenerative kyphosis were enrolled in this study. There were 34 patients in NTLJDK group （TLJA 〈10°） and 43 patients in TLJDK group （TLJA ≥10°）. The median angle of lumbar lordosis （LL） in the NTLJDK or TLJDK groups was 23.40° （18.50°, 29.48°） or 19.50° （13.30°, 24.55°）, respectively. The median TLJAs in all patients and both groups were -11.20° （-14.60°, -4.80°）, -3.70° （-7.53°, -1.73°）, and -14.30° （-17.45°, -13.00°）, respectively. In the NTLJDK group, LLwas correlated with thoracic kyphosis （TK; r = -0.400, P = 0.019）, sacral slope （SS; r = 0.681, P 〈 0.001）, and C7-sagittal vertical axis （r = -0.402, P = 0.018）. In the TLJDK group, LL was correlated with TK （r = -0.345, P = 0.024）, SS （r = 0.595, P 〈 0.001）, and pelvic tilt （r = -0.363, P = 0.0
基金support of the Australian Government Research Training Program Scholarshipthe Sports Medicine Australia Research Foundation,which providcd partial funding towards this study。
文摘Purpose:This study investigated the effects of obesity on breast size,thoracic spine structure and function,upper torso musculoskeletal pain and physical activity participation in women living independently in the community.Methods:A total of 378 women were divided into 3 groups(Not Overweight:body mass index(BMI)=22.5±0.2 kg/m^2(mean±SE);Overweight:BMI=27.4±0.3 kg/m^2;Obese:BMI=35.4±0.3 kg/m^2).Outcome variables of breast volume(mL),thoracic flexion torque(N·m),thoracic kyphosis(degrees),upper torso musculoskeletal pain(score) and time spent in physical activity(min) were calculated and compared among the 3 groups,adjusting for between-group differences in age.Results:There was a significant main effect of BMI on all outcome variables.Participants classified as Obese displayed significantly larger breasts,had greater thoracic flexion torques and reported less time participating in physical activity relative to the participants who were classified as Not Overweight and Overweight.Participants in the Obese group also displayed significantly more thoracic kyphosis and reported significantly more upper torso musculoskeletal pain compared to their counterparts who were classified as Not Overweight.Conclusion:This study is the first to demonstrate that increased obesity levels were associated with compromised kyphosis and loading of the thoracic spine,as well as increased symptoms of upper torso musculoskeletal pain and reduced time spent in physical activity in women living in the community.We recommend further research to determine whether evidence-based interventions designed to reduce the flexion torque generated on the thoracic spine can improve these symptoms of upper torso musculoskeletal pain and the ability of women with obesity to participate in physical activity.
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).
