腰部脊柱管狭窄症患者における立位脊椎アライメントと大腿四頭筋柔軟性の関係

Several studies have reported that the sagittal vertical axis（SVA）in patients with lumbar spinal stenosis（LSS）is associated with health-related quality of life（QOL）and low back pain. Therefore, it is required to obtain optimal standing spinal alignment. However, the functional factors that increase SVA in LSS patients have not been fully clarified. Therefore, the purpose of this study was to investigate correlations between quadriceps flexibility and spinal sagittal alignment in patients with lumbar spinal stenosis（LSS）. We studied 30 LSS patients（16 males, 14 females, age 65.6±12.1 years）. The quadriceps flexibility was evaluated by measuring the heel-to-buttock distance（HBD）, and the standing spine alignment was evaluated by measuring each parameter from the whole spinal column X-ray sagittal plane image. Each relationship was examined using Spearmanʼs rank correlation coefficient. HBD was positively correlated with SVA（r=0.45, p<0.05）and PT（r=0.39, p<0.05）, respectively. It was suggested that quadriceps flexibility was associated with SVA in LSS patients. In conclusion, improving quadriceps flexibility through preoperative physiotherapy intervention may result in good standing spinal alignment in LSS patients. Randomized controlled trials are needed to determine whether increased quadriceps flexibility in LSS patients improves SVA.