요추부 수술시 자세에 따른 요추 시상각의 변화 = Change of Lumbar Lordosis According to the Different Operative Positions

다국어 초록 (Multilingual Abstract)

Study Design : This study is a prospective evaluation of the effect of several operative positions on lumbar sagittal alignment by radiographic analysis of 20 healthy volunteers.
Objective : The purpose of the study was to compare operative tables commonly used for spinal procedures and to determine which positions reproduce normal lumbar lordosis.
Material and Methods : Healthy twenty volunteers aged 20-35 years were enrolled in the study. No subject had a history of low back pain and lumbar surgery. Each volunteer underwent a lateral radiographs with tube to film distance 1 m and beam centered on L3 vertebra. Five radiographs were taken for each volunteer, in standing, prone position on 05I table with 0 hip flexion, 90 hip flexion, 60 hip flexion and prone position on four poster frame with 0 hip flexion. Intervertebral segmental angel from L1 to S1, lordotic angle from L1 to L5 and L1 to S1 were measured using a goniometer with 1 precision. To check intra and inter-observer error of radiography measurements, repeated measurements of radiography by one personnel and three different personnel were done and coefficient of variation was below 5%. Data was analyzed with SPSS and ANOVA was used for a statistical comparison.
Results : All segmental and lumbar lordotic angles showed no statistically significant difference between standing and prone position on four poster frame. All segmental angles, except L1-2 and L2-3 segments, showed no difference between standing and prone position on OSI table with 0 hip flexion. Segmental and lumbar lordotic angles of prone position with 90 hip flexion and 60 hip flexion revealed statistically significant difference from standing position.
Conclusion : Physiologic lordosis values were produced only by the prone position on the four poster frame and prone position on OSI table with 0?hip flexion. Prone positions with 60?and 90?hip flexion resulted in statistically significant decrease in lumbar lordosis.