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

Video：

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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.	岳寿伟. 腰痛的评估与康复治疗进展. 中国康复医学杂志, 2017, 32(2): 136-139.
2.	陈岚岚, 王键. 腰痛运动治疗研究进展. 中国康复医学杂志, 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.	张珊珊, 王楚怀. 腰痛的生物力学基础及临床应用分析. 中国疼痛医学杂志, 2017, 23(8): 602-607.
5.	杜传超, 张衡, 海宝, 等. 脊柱阶段性解剖特点及其损伤的力学机制与诊疗策略. 创伤外科杂志, 2019, 21(7): 552-557.
6.	张洲, 黄真. 腰痛康复治疗的新观念—脊柱节段性稳定性训练. 中国康复医学杂志, 2008, 23(3): 279-282.
7.	武晓丹, 张顺心, 范顺成, 等. 三维有限元分析腰骶椎结构的动态特性. 中国组织工程研究, 2017, 21(15): 2388-2394.
8.	吴建贤, 王斌, 石淑霞. 下腰痛生物力学特点的研究进展. 中华临床医师杂志, 2014, 8(24): 4449-4453.
9.	戴立杨, 张文明, 徐印钦, 等. 人类腰椎活动节段的力学模型. 解剖学报, 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.	张伟, 宫赫, 王丽珍, 等. 腰椎间盘退行性变及损伤的生物力学研究进展. 生物医学工程与临床, 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.	刘慧芳, 熊恩富. 中老年人严重腰腿痛的临床特征与原因探讨. 中国现代医学杂志, 2013, 23(36): 64-67.
16.	郭马超, 鲁世保, 孔超, 等. 关节突关节角度和不对称性在退变性腰椎疾病中的角色. 中国骨与关节志, 2018, 7(10): 772-777.
17.	鲁世荣, 赵杨, 秦晓霖, 等. 骶髂关节(韧带止点劳损)、腰五横突(综合征)的生物力学与下腰痛疾病的相关性研究. 航空航天医学杂志, 2019, 30(1): 26-28.
18.	韩奇, 王晓雷, 陈萌蕾, 等. 循证综述: 慢性腰痛和软组织综合征存在神经病理性疼痛的证据. 中国疼痛医学杂志, 2015, 21(10): 721-731.
19.	王鑫强, 贾瑞钢, 陈彦影, 等. 退变性腰椎滑脱患者腰部多裂肌退变与腰背痛的相关性研究. 实用骨科杂志, 2017, 23(9): 777-780.
20.	王雪强, 陈佩杰. 腰痛常见不良姿势及其运动疗法. 中国疼痛医学杂志, 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.	董荣鹏, 赵建武. 腰椎退变性疾病的治疗进展. 实用心脑肺血管病杂志, 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.	朱立国, 陈忻, 于杰. 非手术治疗退行性腰椎滑脱症的研究概况. 中国中医骨伤科杂志, 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. 岳寿伟. 腰痛的评估与康复治疗进展. 中国康复医学杂志, 2017, 32(2): 136-139.
2. 陈岚岚, 王键. 腰痛运动治疗研究进展. 中国康复医学杂志, 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. 张珊珊, 王楚怀. 腰痛的生物力学基础及临床应用分析. 中国疼痛医学杂志, 2017, 23(8): 602-607.
5. 杜传超, 张衡, 海宝, 等. 脊柱阶段性解剖特点及其损伤的力学机制与诊疗策略. 创伤外科杂志, 2019, 21(7): 552-557.
6. 张洲, 黄真. 腰痛康复治疗的新观念—脊柱节段性稳定性训练. 中国康复医学杂志, 2008, 23(3): 279-282.
7. 武晓丹, 张顺心, 范顺成, 等. 三维有限元分析腰骶椎结构的动态特性. 中国组织工程研究, 2017, 21(15): 2388-2394.
8. 吴建贤, 王斌, 石淑霞. 下腰痛生物力学特点的研究进展. 中华临床医师杂志, 2014, 8(24): 4449-4453.
9. 戴立杨, 张文明, 徐印钦, 等. 人类腰椎活动节段的力学模型. 解剖学报, 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. 张伟, 宫赫, 王丽珍, 等. 腰椎间盘退行性变及损伤的生物力学研究进展. 生物医学工程与临床, 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. 刘慧芳, 熊恩富. 中老年人严重腰腿痛的临床特征与原因探讨. 中国现代医学杂志, 2013, 23(36): 64-67.
16. 郭马超, 鲁世保, 孔超, 等. 关节突关节角度和不对称性在退变性腰椎疾病中的角色. 中国骨与关节志, 2018, 7(10): 772-777.
17. 鲁世荣, 赵杨, 秦晓霖, 等. 骶髂关节(韧带止点劳损)、腰五横突(综合征)的生物力学与下腰痛疾病的相关性研究. 航空航天医学杂志, 2019, 30(1): 26-28.
18. 韩奇, 王晓雷, 陈萌蕾, 等. 循证综述: 慢性腰痛和软组织综合征存在神经病理性疼痛的证据. 中国疼痛医学杂志, 2015, 21(10): 721-731.
19. 王鑫强, 贾瑞钢, 陈彦影, 等. 退变性腰椎滑脱患者腰部多裂肌退变与腰背痛的相关性研究. 实用骨科杂志, 2017, 23(9): 777-780.
20. 王雪强, 陈佩杰. 腰痛常见不良姿势及其运动疗法. 中国疼痛医学杂志, 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. 董荣鹏, 赵建武. 腰椎退变性疾病的治疗进展. 实用心脑肺血管病杂志, 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. 朱立国, 陈忻, 于杰. 非手术治疗退行性腰椎滑脱症的研究概况. 中国中医骨伤科杂志, 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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