Abstract：Objective To quantify the influence of supine position on lumbar lordosis and to evaluate whether lumbar curve would affect the change of lumbar lordosis from standing position to supine position.Methods Fifty female thoracic adolescent idiopathic scoliosis (T-AIS) patients and forty-four female lumbar adolescent idiopathic scoliosis (L-AIS) patients were collected in Spine Surgery of the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2010 to December 2012. The dataes of these patients were retrospectively reviewed in this study. The mean age of T-AIS patients was (14.95±2.82) years and the Cobb angle averaged 47.19°±10.43°. While in L-AIS patients, the age averaged (15.22±2.28) years and Cobb angle 48.12°±9.29°. No difference was found in terms of age and Cobb angle (t=0.506, P=0.614, t=0.439, P=0.661). Patients with history of brace treatment neuromuscular disease, osteopenia, neurological disorders, endocrine disorders, connective tissue diseasesor abnormal intelligence were excluded. The long-cassette standing radiographies and lumbar X-ray lateral films in supine position were obtained from all subjects. Lumbar lordosis (LL) was measured on both standing and supine films. The relationship between standing LL and supine LL was calculated by Pearson correlation in both T-AIS and L-AIS groups. The differences in terms of standing LL, supine LL and ΔLL were also analyzed through independent t test. Statistically significant differences were defined by P<0.05.Results The standing LL averaged in T-AIS group, which was significantly larger than supine LL in the same group (50.49°±8.73° vs. 40.79°±9.89°, t=5.199, P<0.01). Similarly, significant difference was also observed in L-AIS group (51.95°±13.49° vs. 36.37°±11.82°, t=5.762, P<0.01). According to Pearson correlation, strong correlations were observed between standing LL and supine LL in both T-AIS and L-AIS groups(r=0.683, r=0.778, all P values <0.01). The regression formula of standing LL in T-AIS group was ＾YStanding LL=25.913+0.602 XSupine LL; while the formula in L-AIS group was ＾YStanding LL=19.779+0.888 XSupine LL.Conclusions In both T-AIS and L-AIS groups, strong correlations can be found between standing LL and supine LL. The change of LL is more obvious in L-AIS patients. The difference between standing and supine LL should be considered in surgery of L-AIS patients.
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Bao Hongda, Zhu Feng, Qiu Yong, He Shouyu, Yan Peng, Zhou Hengcai, Zhu Zezhang, Liu Zhen. The influence of supine position on lumbar lordosis in adolescent idiopathic scoliosis with or without lumbar curve. Chinese Journal of Anatomy and Clinics, 2014, 19(5): 358-362.
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2014, Vol. 19 
