اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

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کد مقاله 1713

عنوان Adaptive Lumbar Biomechanics: The Interplay Between Lordosis, Spinal Configuration, and Load Distribution

نویسندگان Ashkan Sazrizadeh - Maliheh Jahromi

چکیده Background: The lumbar spine is fundamentally a dynamic and adaptive system, rather than a static structure for which a single ideal shape can be envisioned. Depending on the degree of lordosis, the manner of load application, and the axis of the trunk, this system can redistribute mechanical forces among the various components of the lumbar spine and adapt its configuration to prevailing mechanical conditions.(1, 2) Methods: In preparing this text, we reviewed studies related to lumbar biomechanics, lordosis, and spinal load distribution using PubMed and Google Scholar.(1-5) Findings: From a biomechanical perspective, lumbar lordosis is not merely a superficial anatomical feature. Changes in lordosis alter the distribution of mechanical loads. Specifically, hypolordosis is associated with greater compressive loading of the intervertebral discs, whereas increasing lordosis is associated with greater loading of the facet joints.(1, 5) On the other hand, external load magnitude and distribution can also alter lumbar spinal configuration. Different loading conditions can affect different regions of the lumbar spine. In particular, the upper and lower lumbar regions show changes in opposite directions, suggesting a coordinated postural adaptation to external loading. Consequently, the distribution of lordosis across individual spinal segments may vary substantially, meaning that a single aggregate measure of lumbar lordosis may obscure important biomechanical information.(2, 5) However, varying mechanical conditions, such as flexion, extension, or walking, can also influence the distribution of forces among the components of this system. Muscles and ligaments serve to stabilize the system and partially reduce the dependency between lordosis and load distribution. Intervertebral discs play a similar role, as the pattern of load distribution within them depends on the configuration and mechanical response of the tissues constituting the disc.(3-5) Conclusion: Taken together, these findings suggest that the lumbar spine should not be viewed as a rigid structure defined by a single ideal lordotic angle. Rather, lumbar curvature and segmental alignment can adapt to different loading conditions and postures, thereby redistributing mechanical loads among the intervertebral discs, vertebral bodies, and posterior elements.(1-5)

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