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2022, Vol. 26 ›› Issue (6): 924-928Quantification of the objective index of lumbar disc herniation with body surface topography map: three-dimensional angulation of the elastically fixed turning point of the lower back curveMa Chao1, Wang Fei2, Liu Xiaomin3, Wang Ziyun2, Xu Kui2, Yang Wendong2, Feng Wei2
Abstract: BACKGROUND: The back morphology of patients with lumbar disc herniation presents characteristic manifestations. At present, the judgment of lumbar type is mainly through observation and qualitative description. Professor Feng Tianyou summed up the four steps of “lumbar types” from the perspective of observation: the lumbar curve becomes flat, the lumbosacral upward movement, the rotary basin-buttock, and the rotary waist and chest. OBJECTIVE: To measure the three-dimensional angulation at the turning point of low back curve between type-III/IV and type-I/II patients and analyze the feasibility of judging lumbar type by three-dimensional angulation. METHODS: A total of 110 hospitalized patients with lumbar intervertebral disc herniation were enrolled sequentially, including 70 cases of type-I/II patients and 40 cases of type-III/IV patients. The topographic map of the patient’s back surface was collected through the human spine morphology evaluation system. The analysis software was used to measure the patient’s three-dimensional angulation. The stability of three-dimensional angulation was preliminarily determined. The difference and diagnostic critical value of three-dimensional angulation between type-III/IV and type-I/II patients were calculated, and the authenticity of 3D angle formation was evaluated. RESULTS AND CONCLUSION: (1) The index was stable, and there was no statistical significance in the comparison of the three times for three-dimensional angulation measurement data (P > 0.05). (2) There was significant difference in three-dimensional angulation between type-III/IV and type-I/II patients. Coronal angulation of type-III/IV was 11.04° on average, which was much larger than that of type-I/II (median 1.24°). Sagittal angulation of type-III/IV was 9.02° on average, which was much larger than that of type-I/II (mean 2.96°). Axial angulation of type-III/IV was 9.65° on average, which was much larger than that of type-I/II (mean 3.01°). (3) According to the ROC curve, the diagnostic critical value of three-dimensional angulation (coronal, sagittal, and axial) in III/IV-type patients were 5.43°, 4.77°, and 4.83°, respectively. The authenticity of the three-dimensional angulation results was reliable. The coronal, sagittal, and axial angulation results showed that the sensitivity was 86.66%, 93.33%, and 86.66%; the specificity was 95.23%, 85.72%, and 90.47%. The Youden index was 0.818, 0.790, and 0.771. The total compliance rate was 91.66%, 88.88%, and 88.88%. (4) In this study, three-dimensional topographic map technology of human back surface was used to analyze the feasibility of judging the lumbar type by three-dimensional angulation. It was found that the index had good stability, especially could reflect the characteristics of the rotary basin-buttock, and the rotary waist and chest. Key words:lumbar disc herniation, lumbar types, body surface topographic map, three-dimensional angulation, digital orthopedics |