Discussion and thinking about the causes of biomechanics-related degenerative lumbar spondylosis_West China Medical Journal

Authors：

REN Ling , LEI Zhongjie , YANG Lin , JIANG Junliang ,  XIONG Enfu

Rehabilitation Medicine Centre, West China Hospital, Sichuan University; School of Rehabilitation Sciences, West China School of Medicine, Sichuan University; Rehabilitation Medicine Key Laboratory of Sichuan Province; Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

XIONG Enfu, Email: xiongenfu@126.com

Keywords：

Spinal column biomechanics; Lumbar spine; Chronic pain; Etiology

DOI：

10.7507/1002-0179.201908145

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Biomechanics-related degenerative lumbar spondylosis refers to the diseases of lumbar spine joints, muscles, fascia, and ligaments that related to maintaining lumbar spine mechanical balance and stability, which are mainly manifesting as lumbar pain and lumbocrural pain. The occurrence of biomechanics-related degenerative lumbar spondylosis is related to continuous static load and dynamic load, extra load, and aging. This article describes the etiology of biomechanics-related degenerative lumbar spondylosis, summarizes the functional compensation and structural compensation of losing balance by analyzing the characteristics of human biomechanical balance and the biomechanics of lumbar spondylolisthesis, and interprets the clinical classification of lumbar spondylosis, so as to provide a better reference for the diagnosis and treatment of lumbar spine diseases.

Citation： REN Ling, LEI Zhongjie, YANG Lin, JIANG Junliang, XIONG Enfu. Discussion and thinking about the causes of biomechanics-related degenerative lumbar spondylosis. West China Medical Journal, 2020, 35(10): 1257-1262. doi: 10.7507/1002-0179.201908145 Copy

1.	岳壽偉. 腰痛的評估與康復治療進展. 中國康復醫學雜志, 2017, 32(2): 136-139.
2.	陳嵐嵐, 王鍵. 腰痛運動治療研究進展. 中國康復醫學雜志, 2008, 23(3): 276-279.
3.	Butt AM, Gill C, Demerdash A, et al. A comprehensive review of the sub-axial ligaments of the vertebral column: part I anatomy and function. Childs Nerv Syst, 2015, 31(7): 1037-1059.
4.	張珊珊, 王楚懷. 腰痛的生物力學基礎及臨床應用分析. 中國疼痛醫學雜志, 2017, 23(8): 602-607.
5.	杜傳超, 張衡, 海寶, 等. 脊柱階段性解剖特點及其損傷的力學機制與診療策略. 創傷外科雜志, 2019, 21(7): 552-557.
6.	張洲, 黃真. 腰痛康復治療的新觀念—脊柱節段性穩定性訓練. 中國康復醫學雜志, 2008, 23(3): 279-282.
7.	武曉丹, 張順心, 范順成, 等. 三維有限元分析腰骶椎結構的動態特性. 中國組織工程研究, 2017, 21(15): 2388-2394.
8.	吳建賢, 王斌, 石淑霞. 下腰痛生物力學特點的研究進展. 中華臨床醫師雜志, 2014, 8(24): 4449-4453.
9.	戴立楊, 張文明, 徐印欽, 等. 人類腰椎活動節段的力學模型. 解剖學報, 1991, 21(4): 337-339.
10.	Jebaseelan DD, Jebaraj C, Yoganandan N, et al. Validation efforts and flexibilities of an eight-year-old human juvenile lumbar spine using a three-dimensional finite element model. Med Biol EngComput, 2010, 48(12): 1223-1231.
11.	張偉, 宮赫, 王麗珍, 等. 腰椎間盤退行性變及損傷的生物力學研究進展. 生物醫學工程與臨床, 2015, 19(2): 201-207.
12.	Xu WB, Chen S, Fan SW, et al. Facet orientation and tropism: associations with asymmetric lumbar paraspinal and psoasmuscle parameters in patients with chronic low back pain. J Back Musculoskelet Rehabil, 2016, 29(3): 581-586.
13.	Liu X, Huang Z, Zhou R, et al. The effects of orientation of lumbar facet joints on the facet joint contact forces: an in vitro biomechanical study. Spine, 2018, 43(4): E216-220.
14.	Bi X, Zhao J, Zhao L, et al. Pelvic floor muscle exercise for chronic low back pain. J Int Med Res, 2013, 41(1): 146-152.
15.	劉慧芳, 熊恩富. 中老年人嚴重腰腿痛的臨床特征與原因探討. 中國現代醫學雜志, 2013, 23(36): 64-67.
16.	郭馬超, 魯世保, 孔超, 等. 關節突關節角度和不對稱性在退變性腰椎疾病中的角色. 中國骨與關節志, 2018, 7(10): 772-777.
17.	魯世榮, 趙楊, 秦曉霖, 等. 骶髂關節(韌帶止點勞損)、腰五橫突(綜合征)的生物力學與下腰痛疾病的相關性研究. 航空航天醫學雜志, 2019, 30(1): 26-28.
18.	韓奇, 王曉雷, 陳萌蕾, 等. 循證綜述: 慢性腰痛和軟組織綜合征存在神經病理性疼痛的證據. 中國疼痛醫學雜志, 2015, 21(10): 721-731.
19.	王鑫強, 賈瑞鋼, 陳彥影, 等. 退變性腰椎滑脫患者腰部多裂肌退變與腰背痛的相關性研究. 實用骨科雜志, 2017, 23(9): 777-780.
20.	王雪強, 陳佩杰. 腰痛常見不良姿勢及其運動療法. 中國疼痛醫學雜志, 2014, 20(10): 748-751.
21.	Matsuo Y, Kaito T, Iwasaki M, et al. 3D morphometric analysis of laminae and facet joints in patients with degenerative spondylolisthesis. Mod Rheumatol, 2015, 25(5): 756-760.
22.	Skovlund SV, Bláfoss R, Sundstrup E, et al. Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study. BMC Musculoskelet Disord, 2020, 21: 166.
23.	董榮鵬, 趙建武. 腰椎退變性疾病的治療進展. 實用心腦肺血管病雜志, 2012, 20(6): 948-950.
24.	Samuel AM, Moore HG, Cunningham ME. Treatment for degenerative lumbar spondylolisthesis: current concepts and new evidence. Curr Rev Musculoskelet Med, 2017, 10(4): 521-529.
25.	朱立國, 陳忻, 于杰. 非手術治療退行性腰椎滑脫癥的研究概況. 中國中醫骨傷科雜志, 2014, 22(4): 69-71.
26.	Torrie PA, McKay G, Byrne R, et al. The influence of lumbar spinal subtype on lumbar intervertebral disc degeneration in young and middle-aged adults. Spine Deform, 2015, 3(2): 172-179.

1. 岳壽偉. 腰痛的評估與康復治療進展. 中國康復醫學雜志, 2017, 32(2): 136-139.
2. 陳嵐嵐, 王鍵. 腰痛運動治療研究進展. 中國康復醫學雜志, 2008, 23(3): 276-279.
3. Butt AM, Gill C, Demerdash A, et al. A comprehensive review of the sub-axial ligaments of the vertebral column: part I anatomy and function. Childs Nerv Syst, 2015, 31(7): 1037-1059.
4. 張珊珊, 王楚懷. 腰痛的生物力學基礎及臨床應用分析. 中國疼痛醫學雜志, 2017, 23(8): 602-607.
5. 杜傳超, 張衡, 海寶, 等. 脊柱階段性解剖特點及其損傷的力學機制與診療策略. 創傷外科雜志, 2019, 21(7): 552-557.
6. 張洲, 黃真. 腰痛康復治療的新觀念—脊柱節段性穩定性訓練. 中國康復醫學雜志, 2008, 23(3): 279-282.
7. 武曉丹, 張順心, 范順成, 等. 三維有限元分析腰骶椎結構的動態特性. 中國組織工程研究, 2017, 21(15): 2388-2394.
8. 吳建賢, 王斌, 石淑霞. 下腰痛生物力學特點的研究進展. 中華臨床醫師雜志, 2014, 8(24): 4449-4453.
9. 戴立楊, 張文明, 徐印欽, 等. 人類腰椎活動節段的力學模型. 解剖學報, 1991, 21(4): 337-339.
10. Jebaseelan DD, Jebaraj C, Yoganandan N, et al. Validation efforts and flexibilities of an eight-year-old human juvenile lumbar spine using a three-dimensional finite element model. Med Biol EngComput, 2010, 48(12): 1223-1231.
11. 張偉, 宮赫, 王麗珍, 等. 腰椎間盤退行性變及損傷的生物力學研究進展. 生物醫學工程與臨床, 2015, 19(2): 201-207.
12. Xu WB, Chen S, Fan SW, et al. Facet orientation and tropism: associations with asymmetric lumbar paraspinal and psoasmuscle parameters in patients with chronic low back pain. J Back Musculoskelet Rehabil, 2016, 29(3): 581-586.
13. Liu X, Huang Z, Zhou R, et al. The effects of orientation of lumbar facet joints on the facet joint contact forces: an in vitro biomechanical study. Spine, 2018, 43(4): E216-220.
14. Bi X, Zhao J, Zhao L, et al. Pelvic floor muscle exercise for chronic low back pain. J Int Med Res, 2013, 41(1): 146-152.
15. 劉慧芳, 熊恩富. 中老年人嚴重腰腿痛的臨床特征與原因探討. 中國現代醫學雜志, 2013, 23(36): 64-67.
16. 郭馬超, 魯世保, 孔超, 等. 關節突關節角度和不對稱性在退變性腰椎疾病中的角色. 中國骨與關節志, 2018, 7(10): 772-777.
17. 魯世榮, 趙楊, 秦曉霖, 等. 骶髂關節(韌帶止點勞損)、腰五橫突(綜合征)的生物力學與下腰痛疾病的相關性研究. 航空航天醫學雜志, 2019, 30(1): 26-28.
18. 韓奇, 王曉雷, 陳萌蕾, 等. 循證綜述: 慢性腰痛和軟組織綜合征存在神經病理性疼痛的證據. 中國疼痛醫學雜志, 2015, 21(10): 721-731.
19. 王鑫強, 賈瑞鋼, 陳彥影, 等. 退變性腰椎滑脫患者腰部多裂肌退變與腰背痛的相關性研究. 實用骨科雜志, 2017, 23(9): 777-780.
20. 王雪強, 陳佩杰. 腰痛常見不良姿勢及其運動療法. 中國疼痛醫學雜志, 2014, 20(10): 748-751.
21. Matsuo Y, Kaito T, Iwasaki M, et al. 3D morphometric analysis of laminae and facet joints in patients with degenerative spondylolisthesis. Mod Rheumatol, 2015, 25(5): 756-760.
22. Skovlund SV, Bláfoss R, Sundstrup E, et al. Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study. BMC Musculoskelet Disord, 2020, 21: 166.
23. 董榮鵬, 趙建武. 腰椎退變性疾病的治療進展. 實用心腦肺血管病雜志, 2012, 20(6): 948-950.
24. Samuel AM, Moore HG, Cunningham ME. Treatment for degenerative lumbar spondylolisthesis: current concepts and new evidence. Curr Rev Musculoskelet Med, 2017, 10(4): 521-529.
25. 朱立國, 陳忻, 于杰. 非手術治療退行性腰椎滑脫癥的研究概況. 中國中醫骨傷科雜志, 2014, 22(4): 69-71.
26. Torrie PA, McKay G, Byrne R, et al. The influence of lumbar spinal subtype on lumbar intervertebral disc degeneration in young and middle-aged adults. Spine Deform, 2015, 3(2): 172-179.

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