Analysis of Lumbosacral-Pelvic Parameters in Low Back Pain Patients

요통 환자의 요천추 및 골반 지표 분석

  • Lee, Jin-Hyun (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Jo, Dong-Chan (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Kim, Chang-Gon (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Moon, Su-Jeong (Medical Research Division, Korea Institute of Oriental Medicine) ;
  • Park, Tae-Yong (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Ko, Youn-Suk (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Woo-Suk University) ;
  • Lee, Su-Kyung (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Song, Yung-Sun (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Lee, Jung-Han (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University)
  • 이진현 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 조동찬 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 김창곤 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 문수정 (한국한의학연구원 의료연구부) ;
  • 박태용 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 고연석 (우석대학교 한의과대학 한방재활의학과교실) ;
  • 이수경 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 송용선 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 이정한 (원광대학교 한의과대학 한방재활의학과교실)
  • Published : 2013.04.30

Abstract

Objectives : The aim of this study was to investigate the characteristic of low back pain(LBP) and lumbosacral-pelvic alignments, and the relationship between them, depending on the presence and the duration of LBP. Methods : Ninety six patients were classified into the no LBP group(n=31), the acute LBP group(n=33) and the chronic LBP group(n=32), based on the presence and duration of LBP. In each group, lumbosacral-pelvic indicators were measured. The data were analysed by one way analysis of variance(ANOVA) and pearson correlation. Results : 1. The chronic LBP group showed the lower mean value in Ferguson angle, Lumbar lordosis angle, Pelvic Incidence and difference between left and right iliac height, being compared to acute LBP group. 2. There was not significant correlation between lumbosacral-pelvic alignments and LBP in every group. 3. A positive correlation was found among period of LBP and visual analogue scale(VAS), Oswestry disability index(ODI). Conclusions : For presence and duration of LBP, there were different characteristic values in descriptive statistics. And period of LBP is the most important factor for the degree of LBP. These results show that the lumbosacral-pelvic alignments and LBP have distinctive relationships depending on the duration of LBP.

Keywords

References

  1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354(9178):581-5. https://doi.org/10.1016/S0140-6736(99)01312-4
  2. 보건복지부 한국보건사회연구원. 국민건강 영양조사 3기(2005). 2006:7, 134.
  3. 한태륜, 방문석 외 57인. 재활의학. 제 3판. 서울:군자출판사. 2011:761-81.
  4. Dillingham T. Evaluation and management of low back pain: an overview. State of the Art Reviews. 1995;9:559-74.
  5. Van Dillen LR, Sahrmann SA, Norton BJ, Caldwell CA, McDonnell MK, Bloom N. The effect of modifying patient-preferred spinal movement and alignment during symptom testing in patients with low back pain: a preliminary report. Arch Phys Med Rehabil. 2003;84(3):313-22. https://doi.org/10.1053/apmr.2003.50010
  6. 정성엽, 박영희, 금동호, 이명종, 조윤철. 유병 기간에 따른 요통환자의 Ferguson 각과 요추 중력중심선의 통계적 관찰. 한방재활의학과학회지. 2003;13(1):119-29.
  7. 공재철, 문수정, 조동찬, 고연석, 송용선, 이정한. 만성 요통 환자의 골반지표와 발의 생체역학적 특징 연구. 동의생리병리학회지. 2012;26(1):81-7.
  8. Guldal FN, Aynur K, Nese O. The biomechanics of the lumbosacral region in acute and chronic low back pain patients. Pain Physician. 2008;11(4):505-11.
  9. Reips UD, Funke F. Interval-level measurement with visual analogue scales in internet-based research: VAS generator. Behav Res Methods. 2008;40(3):699-704. https://doi.org/10.3758/BRM.40.3.699
  10. Fairbank JCT, Davis J, Couper J, O'Brien J. The oswestry disability questionnaire. Physiotherapy. 1980;66:271-3.
  11. Stokes IAF, Aronson DD, Ronchetti PJ, Labelle H, Dansereau J. Reexamination of the Cobb and Ferguson angles: bigger is not always better. Journal of Spinal Disorders. 1993;6(4):333-8. https://doi.org/10.1097/00002517-199306040-00007
  12. 이종서, 정성수, 정광훈, 김상림. 이상 척추 시상 만곡의 발현에 있어서 Pelvic incidence가 가지는 의의-전향적 연구-. 대한정형외과학회지. 2006;41(2):274-80.
  13. 조유정, 정석희, 송미연. 만성 요통 환자의 하지 길이 부전과 요천추부 및 골반의 방사선학적 지표와의 관계. 2010;20(4):171-81.
  14. Donald AN. 뉴만 Kinesiology(2nd edition). 서울:법문당. 2011:317-706.
  15. Sam K, Ziya Y. Effect of hyperpronation on pelvic alignment in a standing position. Gait Posture. 2007;25(1):127-34. https://doi.org/10.1016/j.gaitpost.2006.02.005
  16. Jackson RP, Peterson MD, McManus AC, Hales C. Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine. 1998;23(16):1750-67. https://doi.org/10.1097/00007632-199808150-00008
  17. Ward RC. Foundations for osteopathic medicine. 서울:대한추나학회출판사. 1999:1097-106.
  18. Donald A. Neumann. 근골격계의 기능해부 및 운동학. 서울:정담미디어. 2004:519-69.
  19. Criestie HJ, Kummer S, Warren S. Postural aberrations in low back pain. Arch Phys Med Rehabil. 1995;76(3):218-24. https://doi.org/10.1016/S0003-9993(95)80604-0
  20. During J, Goudfrooij H, Keesen W, Beeker TW, Crowe A. Toward standards posture. Postural characteristics of lower back system in nomal and pathologic conditions. Spine. 1985;10(1):83-7.
  21. 한방재활의학과학회. 한방재활의학. 제 3판. 서울:군자출판사. 2011:65-7, 294-301.
  22. 심원보, 김용득, 안영남, 김경식, 손인철. 십이경근과 근육과의 관계에 대한 연구. 대한경락경혈학회지. 2003;20(2):137-53.
  23. Splithoff CA. Lumbosacral juction: roentgenographic comparison of patient with and without backaches. J Am Med Assoc. 1953;152(17):1610-3. https://doi.org/10.1001/jama.1953.03690170024008
  24. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine. 1994;19(14):1611-8. https://doi.org/10.1097/00007632-199407001-00010
  25. Lee CS, Chung SS, Chung KH, Kim SR. Significance of pelvic incidence in the development of abnormal sagittal alignment. J Korean Orthop Assoc. 2006;41(2):274-80.
  26. Legaye J, Duval-Beaupere G. Sagittal plane alignment of the spine and gravity: a radiological and clinical evaluation. Acta Orthop. Belg. 2005;71(2):213-20.
  27. Legaye J, Duval-Beaupere G, Hecquet J, Marty C. Pelvic incidence: a fundamental pelvic parameters for three-dimensional regulation of spinal saggital curves. Eur Spine J. 1998;7(2):99-103. https://doi.org/10.1007/s005860050038
  28. 이동은, 김형길, 조웅희, 박원형, 차윤엽. 요천추부의 정렬과 설문을 통한 요통 자각도의 상호 연관성에 관한 연구. 한방재활의학과학회지. 2011;21(1):115-23.