| 저자 |
Hyundong Kim1, Nami Han1†, Mija Eom1, SangHoon Jung1, YunHo Kim1, JeeYoung Kim1, Heesung Nam1*, JeongHo Kim2 |
Objectives
Spino-pelvic malalignment is one of the most prevalent disorders of the geriatric spine. Once the spino-pelvic alignment deviate from normal range, more energy is required for the body to remain balanced without external support. In geriatric population, the vertical line of center of gravity gradually moves forward with aging, which may results in pain, functional disability and changing spino-pelvic alignment. However it is still unknown whether particular patterns of spino-pelvic alignment are more prevalent in back pain patients. In this study, we measured the relationship between Oswestry disability index(ODI) and Visual analog scale(VAS) to determine the effect of various spino-pelvic alignments on the quality of life and function of patients in geriatric back pain patients.
Methods
108 geriatric patients (45 males, 63 females; mean age 62.71±9.21 years) who have experience of back pain were enrolled. Patients who underwent surgical treatment on spine were excluded.
The following parameters were measured: On lateral and coronal view of whole spine radiographs, saggital vertical alignment(SVA), pelvic incidence(PI), pelvic tilt(PT), sacral slope((SS), pelvic obliquity(PO) and coronal Cobb's angle[Table 2]. For the evaluation of functional status and pain, ODI and VAS were conducted. Patients were divided into minimal disability group(ODI score≤20), moderate disability group(20
Results
General characteristics of the participants are described in Table 1. The average of age was 62.71±9.21 years, and the average of VAS was 3.40 ± 3.63. As the result, SVA, PI, PT showed a statistically significant correlation with ODI.[Table 2] None of the spino-pelvic alignment parameters had correlation with VAS. In the comparison between the ODI group, the higher the SVA, PT, PI and Cobb measured, the higher their ODI scored.[Table 3]
Conclusion
In geriatric back pain patients, SVA, PT and PI have correlation with functional disability measured with ODI. However, VAS, pain itself has no correlation with spino-pelvic alignment. Especially, PT shows significant difference between ODI groups. For the optimal rehabilitation, consideration of targeted modification to spino-pelvic alignment, especially PT and SVA, should be suggested to reduce functional disability of geriatric patients.
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