Characteristics of thoracic and lumbar mobility in patients with degenerative spinal deformity

Abstract

Objective To explore the characteristics of thoracic and lumbar mobility in patients with degenerative spine deformity (DSD). Methods A total of 60 patients with degenerative spine deformity (DSD) admitted in our hospital from May 2018 to May 2021 were recruited in the study, and another 40 healthy individuals who taking physical examination during same period served as control group. The patients including 39 cases of scoliosis convex to the left and 21 cases to the right. A handheld joint actiometer was used to measure thoracic vertebrae left-right lateral flexion, left-right rotation, and lumbar vertebrae flexion and extension, left and right lateral flexion in the deformed group and control group. The parameters, including coronal Cobh angle (CA) and apical vertebra (AV) were measured on the X-ray films of the whole spine in the standing position. The apical vertebra rotation (AVR) was measured on the cross-sectional T2W1 image of MRI. Differences in thoracic and lumbar vertebrae range of motion (ROM) were compared between the 2 groups, and the correlation of thoracic and lumbar vertebrae ROM with AVR and CA angle were analyzed in the deformed group. Results The overall ROM of the lumbar lateral flexion, flexion, extension and the ROM of the thoracic vertebra rotation were significantly smaller than those of the control group (P < 0.01). In the left-sided curved deformities, the lumbar flexion, extension, lateral flexion (concave) and thoracic rotation (concave, convex) were significantly smaller than those in the control group (P < 0.05). In the right-sided curved deformities, the lumbar extension, lumbar flexion (concave, convex), and thoracic rotation (concave, convex) were significantly small than in the control group (P < 0.05). In the deformed group, the lumbar lateral flexion (convex) was significantly negatively correlated with both CA angle (r=-0.282, P=0.035) and AVR (r=-0.343, P=0.010). Conclusion DSD patients have limitations in spinal mobility in all directions. The mobility limitation for lumbar spine mainly focuses on flexion and extension (sagittal plane) and lateral flexion (coronal plane), while mobility limitation for thoracic vertebrae mainly concentrates on rotation. The lateral flexion mobility on the convex side are closely associated with the Cobb angle and AVR.

Keywords

• degenerative spinal deformity
• thoracic vertebrae
• lumbar vertebrae
• range of motion