Decreased Lumbar Lordosis Research Articles

腰部脊柱管狭窄症に対するＦｌｅｘｉｏｎ Ｂｒａｃｅ療法

The efficacy of flexion brace in the treatment of lumbar cannal stenosis was evaluated on 42 patients (questionnaire, 42; consultation, 26). Improvement of symptoms was obtained in 78.6% of them. Intermittent claudication was favorably relieved after the bracing and an average walking distance had increased from 220m to 1013m. Radiographic assessment of 25 patients who had worn the flexion brace revealed that most of them showed slight blocking of lumbar extension and mild decrease in lumbar lordosis. The results in patients with spodylosis deformans were significantly good compared with degenerative spodylolisthesis or spondylolytic spondylolisthesis.

Gait abnormalities arising from latrogenic loss of lumbar lordosis secondary to Harrington instrumentation in lumbar fractures.

Six patients with lumbar fractures were studied at the Pathokinesiology laboratory at Rancho Los Amigos Hospital following posterior Harrington distraction instrumentation to identify changes in posture and gait associated with iatrogenic loss of lumbar lordosis. Three patients, all with painful rods, were treated with standard Harrington instrumentation and full length fusion. Three patients were treated with so-called "rodded long-fused short" procedures. It was thought that rod removal in the latter group would result in restoration of lumbar lordosis with concomitant improvement in posture and gait when compared to the full length fusion group. No significant difference between the two groups was found. Rod removal often resulted in kyphotic collapse at the previous fracture site despite solid posterior arthrodesis with net decrease in lumbar lordosis. Hip hyperextension, when available, was the favored compensatory mechanism for loss of lumbar lordosis. Otherwise, hip flexion and forward lean of the trunk was seen.

THE SPINE DEFORMITY OF THE C. V. A. HEMIPLEGIC PATIENT

The spine deformity following C. V. A. hemiplegia was investigated from the roentogenological study of 54 patients.1) The prevalence of scoliosis was 24.1per cent. And it's average angle was 19.6± 6.8 degree.2) There were 8 C-curves and 5 S-curves. C-curve developed in 4 right hemiplegic patients and 4 left hemiplegic patients, and S-curve developed in 5 left hemiplegic patients and 1 right hemiplegic patient. C-curve had convexity toward the paralysed side except one case, on the other hand S-curve had convexity toward the intact side except one case.3) There was no relationship between scoliosis and the Brunnstrom's recovery stage.4) There was no relationship between scoliosis and the period after onset of C. V. A. hemiplegia.5) 2 of 4 patients with help of wheel chair and 5 of 16 patients with S. L. B. and T cane and 6 of 15 patients with T cane had scoliosis.On the other hand, there was no scoliosis in patients who walked for themselves.6) Compared with patients who had no scoliosis, scoliosis patients had increased thoracic kyphosis and decreased lumbar lordosis.