Dissertations / Theses on the topic 'Lumbar lordosis'

Foi avaliada a participação dos corpos vertebrais e discos intervertebrais na lordose lombar e, a contribuição destes nas curvaturas lombares de diferentes magnitudes. Foram avaliadas as radiografias lombares em perfil de 350 adultos assintomáticos (143 homens e 207 mulheres, idade média 29 anos). Foram mensuradas a curvatura lombossacra (L1S1), a curvatura lombolombar (L1L5), a angulação de cada corpo vertebral e cada disco intervertebral por meio de uma variação do método de Cobb. A participação percentual dos corpos vertebrais e dos discos intervertebrais na curvatura lombossacra também foi determinada. Comparações entre os sexos e as faixas etárias foram realizadas. Os indivíduos foram divididos em três subgrupos populacionais, de acordo com a magnitude da lordose lombossacra, de modo a separar os indivíduos pertencentes aos extremos da curva de distribuição. Os componentes da curvatura lombar (corpos vertebrais e discos intervertebrais) foram comparados nestes três subgrupos. A medida da curvatura lombossacra no grupo inicial foi -60,9o (-33o a -89o). Os corpos vertebrais eram cifóticos em L1 (2,15o), tendiam ao neutro em L2 (-0,36o) e eram progressivamente lordóticos de L3 (-1,56o) a L5 (-9,23o). Os discos intervertebrais eram progressivamente lordóticos (variando de -4,99o em L1-L2 a -15,58o em L5-S1). Os corpos vertebrais e discos intervertebrais apresentaram participação progressivamente maior na curvatura lombossacra no sentido crânio-caudal. Os discos intervertebrais participaram com cerca de 80% da curvatura lombossacra, sendo que os elementos mais caudais (corpos vertebrais L4 e L5 e discos intervertebrais L4-L5 e L5-S1) corresponderam a mais de 65% da curvatura lombossacra. Os indivíduos mais velhos apresentaram medidas das curvaturas lombares maiores cerca de 4º em comparação aos indivíduos mais jovens, havendo diferença significante para as medidas dos corpos vertebrais L2 e L5 e o disco intervertebral L3-L4, sendo maiores as medidas nos indivíduos mais velhos. As medidas das curvaturas lombares e dos corpos vertebrais L2 e L4 apresentaram diferença estatisticamente significante entre os sexos, sendo as medidas maiores nos indivíduos do sexo feminino. A curvatura lombossacra apresentou média de -46,9° no subgrupo lordose menor; -61,59° no subgrupo lordose intermediária e; -74,13° no subgrupo lordose maior. A curvatura lombolombar apresentou média de -33,28° no subgrupo lordose menor; -45,34° no subgrupo lordose intermediária e; -56,96° no subgrupo lordose maior. Os corpos vertebrais e os discos intervertebrais apresentaram medidas absolutas menores no subgrupo lordose menor do que as dos subgrupos lordose intermediária e lordose maior, mas a participação dos discos intervertebrais na curvatura lombossacra no subgrupo lordose menor (88%) foi maior que nos subgrupos lordose intermediária (81%) e no subgrupo lordose maior (75%). Complementarmente, os corpos intervertebrais apresentaram maior participação nos subgrupos lordose maior e lordose intermediária. Individualmente, os corpos vertebrais apresentaram maior participação no subgrupo lordose maior, exceto pelo corpo vertebral L5 que apresentou maior participação no subgrupo lordose menor. A maior participação percentual dos discos intervertebrais no subgrupo lordose menor era devida à inclinação cifótica dos corpos vertebrais mais cefálicos (especialmente L1 e L2) no subgrupo lordose menor do que nos demais subgrupos, que, por um efeito compensatório, causava uma maior participação discal nas curvaturas menores. Os demais subgrupos apresentavam os corpos vertebrais cefálicos com inclinação muito mais lordótica do que o observado no subgrupo lordose menor. Concluímos que os discos intervertebrais são os principais responsáveis pela curvatura lombar e que a contribuição dos corpos vertebrais e discos intervertebrais na lordose lombar difere entre indivíduos com curvaturas de diferentes magnitudes. Apesar de ocorrer um aumento gradual do acunhamento lordótico do corpo e disco a cada nível vertebral conforme aumenta a medida da lordose, as vértebras mais cefálicas provocam uma diferença na contribuição percentual entre discos intervertebrais e corpos vertebrais nas curvaturas de tamanhos diferentes.
The vertebral bodies and intervertebral discs participation in lumbar lordosis and their contribution between lumbar curves of different size were studied. 350 lumbar spine radiographs of asymptomatic adults (143 men and 207 women, average age 29 years) were evaluated. Lumbosacral (L1S1) and lumbolumbar (L1L5) curves and the angular inclination of each vertebral boby and intervertebral disc were measured using a Cobb method variant. The percentile participation of each vertebral body and intervertebral disc in the lumbossacal curve was calculated. Sex and age were compared. The subjects were separated in tree subgroups, in acording to lumbosacral curve size. The compounds of lumbar curve (discs and vertebrae) were compared in these tree subgroups. The mean lumbosacral curve was ?60,9º (-33º to ?89º). L1 vertebral body was kyphotic (2,15º), L2 was neutral (-0,36º), and the other ones were progressively lordotic from L3 (-1,56º) to L5 (-9,23º). The intervertebral discs were progressively lordotic from L1-L2 (?4,99º) to L5-S1 (?15,58º). Both vertebrae and discs showed a progressive participation in cephalic-caudal direction. The participation of discs was about 80% of lumbosacral curve, and the caudal elements (L4, L5 vertebrae and L4-L5, L5-S1 discs) contributed far 65% of the curve. The older subjects presented lumbar curves larger than younger 4º average, with significant statistical difference to L2, L5 and L3-L4 measures, with older subjects presenting bigger angular values. There were statistical differences of lumbar curves, L2 and L4 measures between sexes, with females presenting bigger values. The lumbosacral curve presented average -46,9º in minor lordosis subgroup, -64,59º in intermediate lordosis sugbroup, and ?74,13º in major lordosis subgroup. The lumbolumbar curve presented average ?33,28º in minor lordosis subgroup, -45,34º in intermediate lordosis subgroup, and ?56,96º in major lordosis subgroup. The absolut values of vertebrae and discs angles were smaller in minor lordosis subgroup than in major lordosis subgroup, but the intervertebral discs participation of was bigger in minor lordosis subgroup (88%) than intermediate lordosis (81%) and major lordosis (75%) subgroups. Complementarely, the vertebrae had a bigger participation in intermediate and major lordosis subgroups. Individually, the vertebrae presented a larger participation in major lordosis subgroup, excepting L5 that presented bigger participation in minor lordosis subgroup. The discs presented larger participation in minor lordosis subgroup. That is consequence of a more kyphotic inclination of the cephalic vertebrae in minor lordosis subgroup than the other ones, causing a compensating effect, with a larger disc participation in the small curves. The intermediate and major lordosis subgroups had the cephalic vertebrae more lordotic than that of the minor lordosis subgroup. We concluded that the intervertebral discs are the main responsible for the lumbar curve angulation and that the contribution of vertebrae and discs in lumbar curves of different sizes is not equal. In spite of a gradual increase of lordotic wedging while lumbar curve increase, the cephalic vertebrae make the disc and vertebrae participation different between different magnitude lumbar curves.

The dimensions of the lumbar vertebrae are examined in order to determine if these measurements can be used to predict the age of an individual, and if the lumbar vertebrae exhibit sexual dimorphism. Various statistical techniques were utilized to analyze several dimensions of the lumbar vertebrae. Aging patterns in the lumbar elements are distinct between males and females, and females exhibit compression of the L3 element, which may be related to vertebral wedging. Some dimensions of the lumbar vertebrae are sexually dimorphic.

Objetivo: métodos antropométricos que quantifiquem as curvas da coluna vertebral e a avaliação postural a fim de realizar investigações epidemiológicas sobre o papel da postura na ocorrência das dores lombares. O propósito do estudo foi avaliar acurácia e reprodutibilidade do Sistema de Avaliação Postural Digitalizado (SAPD) para medir lordose lombar comparando com raio-x. Delineamento: transversal, com amostra consecutiva. Participantes: para medida da acurácia no grupo 1 ( T12,L3,L5) n = 16 e grupo 2 (L1,L3,L5) n= 17. Na reprodutibilidade intra e inter-avaliador n= 80. Principais Medidas: marcadores externos nos processos espinhosos das vértebras T12, L1, L3 e L5. Raio-x de perfil da coluna lombar e foto digital em perfil direito. Medida da lordose lombar no raio-x com métodos de Cobb,Centróide (CLL) e Processos Espinhosos (PE) e com o SAPD. Resultados: grupo 1, correlação entre SAPD e Cobb foi 0,803 (p<0,001), entre SAPD e CLL foi 0,642 (p=0,024), entre SAPD e a medida dos PE a correlação foi 0,917, com R2 = 0,842. No grupo 2, correlação entre SAPD e Cobb foi 0,559 (p=0,020), entre SAPD e CLL de 0,325 (p=0,302), com correlação significativa somente entre SAPD e Cobb. Entre SAPD e PE a correlação foi 0,763, com R2 = 0,583. Para reprodutibilidade interavaliador a correlação foi 0,981 (p < 0,001) e para reprodutibilidade intra-avaliador de 0.978 (p < 0,001) referente às mesmas fotografias. Reprodutibilidade intraavaliador de 0.872 (p < 0.001) e 0.956 (p<0,001) para inter-avaliador referente à fotos diferentes de um mesmo indivíduo com recolocação dos marcadores sobre a pele . Considerações Finais: O SAPD mostrou-se acurado e reprodutível para a medida da lordose lombar.
Aim: Antropometric approaches to estimate postural alignment are important to permit epidemiologic investigations of the role of posture in the development of lumbar back pain.The aim of this study was evaluate the accuracy and reliability of the Digitalizing Posture Evaluation System (DPES) in the measurement of lumbar lordosis compared with radiographic measurement (gold standard). Design: cross-sectional study. Participants: Accuracy study Groups markers of (T12,L3,L5) and markers of (L1,L3,L5) were composed of 16 and 17 patients repectively. The intra and interobserver reliability group was composed of 80 patients. Principal measures: Skin markers were placed on spinous processes of T12 or L1,L3 and L5. Lateral radiographs and photographs were taken in the upright position. Radiographic measurement using Cobb, Centroid (CLL) and Spinous Process methods was compared with DPES. Results: Group 1: Correlation coefficient between DPES and Cobb was 0,803 (p<0,001); between DPES and CLL 0,642 (p<0,001); between DPES and SP 0,917 (p < 0,001) with r² = 0,842. Group 2: correlation coefficient was 0,559 (p=0,020) between SP and Cobb; 0,325 (p=0,302) between SP and CLL; and 0,763 between SP and DPES.The reliability coefficients were 0,981 (p<0,001) for interobserver and 0,978 (p<0,001) for intraobserver measurement of the same photographs. Comparing diferent photographs, the reliability was 0,956 (p<0,001) for interobserver and 0,872 (p< 0,001) for intraobserver evaluations. Conclusion: The DPES method correlated well with radiographic measurement of lumbar lordosis.

Profesor especializado en danza
La formulación de este trabajo está orientada hacia los estudiantes de la Etapa Básica y el Primer año Superior de la carrera de Licenciatura en Artes con mención en Danza de la Facultad de Artes de la Universidad de Chile y se contextualiza primeramente en una breve descripción de los aspectos necesarios para entender el tema en cuestión, referente a la anatomía de la postura humana y sus desequilibrios. Éstos se fundamentan en los estudios de anatomía y fisiología del cuerpo humano y enfatizan en las estructuras óseas y musculares en donde se localiza el problema postural de la hiperlordosis lumbar, como son la columna vertebral y la pelvis. De igual manera, define los componentes del centro de energía y la forma de trabajarlo en Pilates, paralelo a un enfoque específico de la danza Contemporánea referente al sistema de trabajo Laban-Bartenieff, el cual no es aplicado directamente en todas las asignaturas de la Licenciatura, sin embargo muchas utilizan conceptos y conexiones aplicadas a la postura y el movimiento. En conjunto con las entrevistas y observaciones y de acuerdo a las competencias requeridas en los primeros años de estudio de la carrera de Danza versus las condiciones y habilidades de cada estudiante con respecto a su condición de hiperlordosis lumbar, se realizó una propuesta de ejercicios a modo de programa. Éste se origina en la aplicación del trabajo de Suelo del Método Pilates Clásico o Auténtico, el cual incluye rutinas específicas que les permitirán a los estudiantes localizar el centro de energía para entregar soporte desde él a todo el resto del cuerpo, mejorando su conciencia corporal y optimizando su alineación postural, por tanto, la eficiencia energética y la mecánica corporal.

Bien que les orthèses lombaires (OL) soient couramment employées depuis de nombreuses années dans le traitement conservateur des lombalgies, leurs effets mécaniques et posturaux restent, à notre connaissance, partiellement inexplorés. Des obstacles d'ordre méthodologique en sont la principale cause avec en premier lieu la difficulté d'évaluer les effets des OL à l'intérieur du tronc sans être invasif et sans nécessiter un équipement coûteux difficilement utilisable lors de la pratique médicale courante. La levée de ces verrous scientifiques a guidé l'ensemble de ce travail doctoral à travers le développement d'une méthodologie spécifique. L'effet mécanique a été étudié à partir d'une nouvelle méthode non-invasive de mesure de la pression intradiscale réalisée à partir d'une modélisation par éléments finis contrôlée par radiographie. Les premiers résultats ont démontré la possibilité de diminuer de 15 à 22% en moyenne la pression intradiscale lors du port d'une OL modifiant la statique rachidienne. Les différents travaux sur l'équilibre postural ont permis de définir une méthodologie d'analyse de la posture en station debout puis assise adaptée à l'évaluation des OL. Les premiers résultats chez des patients lombalgiques subaiguës ont mis en évidence un contrôle postural plus efficient (réduction de la raideur active du tronc) lors du port de l'OL la plus rigide. A terme, cette méthodologie facile à mettre en œuvre permettra d'adapter les caractéristiques du produit (raideur passive / forme) aux caractéristiques des patients (raideur active / courbure lombaire) dans le but d'optimiser l'efficacité clinique

碩士
義守大學
工業管理學系
90
In order to understand the influences of pilot’s lumbar lordosis on the sustainability for ejection impact, this study measured the characteristic angles of lumbar lordosis from 112(?) helicopter crews of the ROC Army. Two lumbar lordotic angles were measured: the first measure was between L1 and L5 (LLAΙ); the second one was between L2 and L5 (LLAⅡ). The mean values of LLAΙand LLAⅡ were 31.42 ± 10.11 o and 34.16 ± 9.39 o , respectively. Besides, the lumbosacral angle and sacral inclination angle were 14.05 ± 5.84 o and 42.58 ± 9.15 o, respectively. No significant difference was noted in lumbar lordotic angle (LLAΙ) between helicopter crews and normal adults, but there was a statistically significant difference between helicopter crews and western normal males (LLAⅡ). This study also designed a lumbar model with variable lordosis for a 50 %ile dummy, and used it to be the subject in ejection experiments. The results of the ejection experiment showed that the acceleration for the lumbar with normal lordosis was smaller than the more lordotic or straight lumbar. The results also revealed that increasing of the abdominal pressure had a potential to decrease the loads on the lumbar spine. In addition to ejection experiments, this study also established a finite element spine model to simulate a thoraco-lumbar spine under ejection impacts. The results of FE simulation showed that both of a larger lorditic angle and a higher ejecting onset rate increased the stress distributed on lumbar spine. To summarize the results of experiments and simulation may conclude that the lumbar lordosis will moderately vary the lumbar loading during sustaining ejection impact, and further studies are needed to benefit the pilot’s safety.

M.Tech. (Chiropractic)
Purpose: Low back pain affects the general population worldwide. Low back pain is a multi-factorial problem with debate as to the exact aetiology of low back pain. Thus, this study examines the relationship between lumbar spine lordosis, body fat percentage, physical activity level, lumbar spine range of motion and the incidence of low back pain. Method: There was a total of one hundred female participants between and including eighteen and thirty-five years of age. These females were symptomatic or asymptomatic of mechanical low back pain. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Participants were evaluated once. No treatment was administered. Procedure: Subjective responses were acquired through the Visual Analog Scale, the International Physical Activity Questionnaire and an Oswestry Low Back Pain and Disability Questionnaire. The objective evaluation included a physical examination and a lumbar spine regional examination. The participant’s height was measured using a stadiometer. The Bioelectrical Impedance Analysis (BIA) measured the participant’s weight, water content, lean tissue mass and body fat percentage. BMI was calculated from the weight and height recordings. Range of motion of the lumbar spine was measured with a Digital Inclinometer. A flexi curve ruler molded the lumbar spine lordosis of each participant, which was then traced onto a piece of paper to measure the magnitude of lumbar spine lordosis. Results: A clinical relationship did not exist between a hyperlordotic lumbar spine posture, the incidence of low back pain, body fat percentage and lumbar spine range of motion. A clinical relationship was evident between a hyperlordotic lumbar spine posture and the level of physical activity. Conclusion: Given that a clinical relationship exists between a hyperlordotic lumbar spine posture and the level of physical activity, physical activity specifically exercise to strengthen the abdominal muscles should be included in a treatment protocol to reduce the degree of lumbar spine lordosis if the degree is excessive.

Dissertação de mestrado em Engenharia Mecânica
Low back pain affects a big percentage of the world population and it incurs an economic burden to the patients and the country’s economy. This condition is generally associated with high strain on the lumbar column, due to its function in weight support and movement stability. When conservative treatments are no longer effective, the patient is submitted to surgical procedures such as lumbar interbody fusion procedures. This involves replacing the intervertebral disc by an implant. The evolution of the interbody fusion procedures to minimal invasive ones creates the necessity of developing new fusion devices. The motivation of this thesis originates directly from that need. The present work aims to study and develop an adjustable interverbal fusion cage capable of filling some of the voids in the market and give answers to the need of specific fusion cages for minimal invasive surgeries. The intervertebral fusion cage developed is adaptable, allowing the adjustment of its height and lordosis, by regulating the height in two parallel axis. With minimal invasive procedures in mind, it presents a range of lordosis up to eight degrees and a varying height of 7.23 to 10.23 mm. Merely a computational prototype, no physical device was produced and submitted to proper testing.
A lombalgia afeta uma grande percentagem da população mundial e gera grandes custos para o paciente e para economia do seu país. Esta condição esta geralmente associada com um elevado stress na coluna vertebral, devido ao seu papel no suporte de peso e estabilidade de movimentos. Geralmente leva a necessidade de intervenção cirúrgica, como é o caso da fusão intersomática lombar, que envolve a substituição do disco intervertebral por um implante. Os processos médico relativo a este procedimento tem sido desenvolvidos e evoluído para opções menos invasivas, criando a necessidade de desenvolver novos implantes. A motivação desta dissertação deriva dessa necessidade. O presente trabalho procura estudar e desenvolver um mecanismo ajustável para fusão intervertebral capaz de preencher as lacunas do mercado e dar resposta as necessidades especificas de implantes para cirurgias menos invasivas. O implante desenvolvido é adaptável, pelo que permite variação da altura e da lordose, através da regulação da altura em dois eixos paralelos distintos. Tendo em conta cirurgias menos invasivas, o dispositivo é capaz de uma variação de oito graus em lordose e permite ajustar a sua altura de 7.23 mm até 10.23 mm. O implante é apenas um protótipo computacional, sendo que não foi criado um modelo físico e devidamente testado.

碩士
國立臺灣大學
物理治療學研究所
104
Background Psoas major (PM) is the only muscle that attaches to both lumbar spine and hip joint. Anatomical and biomechanical studies revealed that PM contraction could increase segmental compressive force that leads to an increase in lumbar stability and also controls lumbar lordosis. Patients with low back pain (LBP) had different lumbar curvatures and neuromuscular recruitment strategies in sitting positions. Several studies indicated that patients with unilateral LBP showed significant reductions in PM cross-sectional areas at their symptomatic sides of their backs but most of them are static MRI approaches. Therefore, it is warranted to investigate whether PM thickness changes differently during dynamic lumbar lordosis maneuver between patients with unilateral LBP and healthy populations using a dynamic imaging approach. Purpose There are two purposes of this study. First, to investigate whether the neuromuscular control of PM and erector spinae muscle during lumbar lordosis maneuver are different between unilateral LBP and healthy individuals. Second, to investigate whether the neuromuscular control of PM and erector spinae during lumbar lordosis maneuver are different between painful side and non-painful side in the LBP population. Methods Both LBP patients and healthy subjects were recruited in this study, and patients with unilateral LBP were recruited from National Taiwan University hospital. Besides recording basic data, PM and erector spinae muscle were measured by ultrasonography and surface electromyography respectively during lumbar lordosis maneuver simultaneously in different contraction levels for each subjects. Data were analyzed using SPSS18.0 version, and were presented as means ± standard deviations and percentages. Mann-whitney u test were used to analyze the ratios of thickness changes in PM, erector spinae EMG magnitudes between groups (unilateral LBP, healthy) and Wilcoxon Signed Rank test were used to analyze outcome measures between sides (painful side, non-painful side) during different contraction levels. The significance level was set at α< 0.05. Results: A total of twenty-three participants enrolled in this study. (Healthy:13; LBP:10) Significant group differences in age (Healthy: 21.4 ± 2.5 y/o; LBP: 25.4 ± 4.1 y/o) and BMI (Healthy: 21.3 ± 0.5 Kg/m2; LBP: 23.5 ± 1.1 Kg/m2) were detected. Mann-Whitney U test revealed that there were significant group differences in ratios of PM thickness changes in higher contraction levels (40-25mmHg: Healthy: 23.2± 14.6 %; LBP:11.1 ± 4.1 %, p=0.006; 40-20mmHg: Healthy: 29.2 ± 15.7 %; LBP:12.2 ± 6.5 %, p=0.001). There were no significant group differences in erector spinae muscle activities in all contraction levels. Within unilateral LBP group, there were no side to side differences in ratios of PM thickness changes and erector spinae muscle activities in all contraction levels. Conclusion: There was a significant reduction in ratios of PM thickness changes during dynamic lumbar lordosis maneuver in persons with unilateral LBP when compared to healthy controls. Furthermore, ultrasound can be a feasible tool in clinical practice to examine PM thickness changes in a non-invasive, dynamic approach.

The thesis deals with creating and verifying of a set of compensatory excercises for children of younger school-age devoted to modern gymnastics. The experiment ran with two gymnastic groups from Prachatice and Volary. Every girl underwent an examination of hyperlordosis degree and a muscle strength and stretch level. Finally, it was proved that these girls suffer from hyperlordosis indeed. Therefore a set of excercises had been created and later applied on the girl gymnasts. Five months later the second measuring was realised and proved that the experiment was a success.