Changes of spino-pelvic parameters during a gait cycle in patients with lumbar disc herniation and their corre-lations with lumbago-leg pain
Objective:To analyze the changes of spino-pelvic parameters(SPPs)during a gait cycle in patients with lumbar disc hernia-tion(LDH),and to explore their correlations with lumbago-leg pain.Methods:Fourteen LDH patients(LDH group),and 17 healthy individ-uals(healthy control group)were enrolled in the study.The walking processes of the subjects in the 2 groups were recorded by optical motion capture system(OMCS)in the motion capture experimental site.The collected data was processed by using specific algorithms,and the curve charts of changing trend of SPPs throughout the gait cycle was plotted.After that,the mean values(the ratio of the sum of the values to the number of values of a index)and ranges(the difference between the maximum and minimum values of a index)of coronal balance distance(CBD),sagittal vertical axis(SVA)distance,thoracic kyphosis(TK),lumbar lordosis(LL),pelvic tilt(PT),and pelvic incidence(PI)dur-ing the gait cycle were extracted and compared between the 2 groups.Furthermore,the correlations between the SPPs in the gait cycle and the visual analogue scale(VAS)scores of low back pain and leg pain in LDH patients were analyzed by using Pearson correlation analysis.Results:①During the gait cycle,the CBD presented a periodic increase or decrease trend,the SVA distance,TK,LL,and PT exhibited a trend manifesting as cosine curve,while the PI remained essentially unchanged.During the gait cycle,the mean values of CBD and LL were smaller,while the mean values of SVA distance and PT were greater in LDH group compared to healthy control group((0.0,23.9)vs(2.0,1.8)mm,Z=-2.024,P=0.043;(37.1,19.2)vs(42.1,15.6)degrees,Z=-1.945,P=0.043;(35.4,30.0)vs(13.0,28.1)mm,Z=-2.898,P=0.004;(18.6,12.5)vs(9.2,13.4)degrees,Z=-2.104,P=0.035),and the comparison of the mean values of TK and PI revealed no significant differences between the 2 group((10.1,11.3)vs(12.8,8.7)degrees,Z=-0.913,P=0.361;(44.1,14.8)vs(49.4,7.9)degrees,Z=-1.429,P=0.153).During the gait cycle,the ranges of SV A distance and PT were greater,while the ranges of TK and LL were smaller in LDH group compared to healthy control group((29.7,15.6)vs(15.8,2.1)mm,Z=-2.898,P=0.004;(5.3,0.7)vs(3.3,1.3)degrees,Z=-3.971,P=0.000;(4.5,0.9)vs(5.3,1.1)degrees,Z=-2.541,P=0.011;(7.4,2.0)vs(11.3,1.1)degrees,Z=-4.010,P=0.000),and the comparison of the ranges of CBD and PI revealed no significant differences between the 2 group((37.5,17.0)vs(34.8,5.2)mm,Z=-0.595,P=0.552;(0.6,0.1)vs(0.6,0.1)degrees,Z=-1.155,P=0.262).②The results of Pearson correlation analysis showed that the low back pain VAS score was negatively correlated with the range of LL(r=-0.880,P=0.000),but was positively correlated with the ranges of TK and PT,respectively,during the gait cycle in LDH patients(r=0.766,P=0.001;r=0.833,P=0.000);furthermore,the leg pain VAS score was positively correlated with the mean value of SVA distance and the range of CBD,respectively(r=0.653,P=0.011;r=0.752,P=0.002),whereas the mean values and ranges of other SPPs were not correlated with the low back and leg pain VAS scores during the gait cycle in LDH patients.Conclusion:The differences in SPPs such as CBD,SVA distance,LL,TK and PT during the gait cycle are significant between LDH patients and healthy individuals.The ranges of LL,TK and PT are associated with the degree of low back pain,whereas the mean value of SVA distance and the range of CBD are correlated with the degree of leg pain in LDH patients.
intervertebral disc displacementgaitspinepelvisthree dimensional motionparametersdynamic capture technologypaincorrelation of data
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