Changes in Lumbosacral Angles in Patients with Chronic Low Back Pain: A Prospective Study

Ali Akbar Esmailiejah¹, Mohamad Qoreishy^1, , Ali Keipourfard¹ and Shahrzad Babaei¹

¹Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Cite this paper

Ali Akbar Esmailiejah, Mohamad Qoreishy, Ali Keipourfard and Shahrzad Babaei. Changes in Lumbosacral Angles in Patients with Chronic Low Back Pain: A Prospective Study. American Journal of Medical Case Reports. 2017; 5(6):163-165. doi: 10.12691/AJMCR-5-6-8

Abstract

Objective: A prospective study of several radiographic parameters of sagittal profile of the spine was conducted to determine the clinical values of these parameters. Methods: The lumbar lordotic curve was measured as Lumbar Lordotic Angle (LLA), Lumbosacral Angle (LSA), Sacral Horizontal Angle (SHA) and our suggested new parameter, Lumbar Sagittal Balance Axis (LSBA). We compared the association between LLA, LSA, SHA and LSBA in 100 patients with chronic low back pain (LBP) and 100 control group. Results: LSA was statistically significant in male ones in patients and control group (P=0.0001) but this angle didn’t showed a significant difference without the effect of gender. SHA angle didn’t show any statistical significance in patients with LBP. A significant correlation was observed between LSBA increase and LBP (P=0.001). Conclusion: Measurement of LSAs and LSBAs may provide orthopedic surgeons some appropriate parameters to predict acute to chronic LBP transformation risks.

Keywords

Lumbar Lordotic Angle, Lumbosacral Angle, Sacral Horizontal Angle, Lumbar Sagittal Balance Axis, Low Back Pain

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Urwin, M., Symmons, D., Allison, T., Brammah, T., Busby, H., Roxby, M., Simmons, A., “Williams, G., “Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation,” Annals of the rheumatic diseases, 57(11):649-55. 1998.
[2]	Amonoo-Kuofi, US., “Changes in the lumbosacral angle, sacral inclination and the curvature of the lumbar spine during aging,” Acta Anat (Basel), 145(4):373-7. 1992.
[3]	Pope, M.H., Novotny, J.E., “Spinal biomechanics,” J Biomech Eng, 115(4B):569-74. 1993.
[4]	Tüzün, C., Yorulmaz, I., Cindaş, A., Vatan, S., “Low back pain and posture,” Clin Rheumatol, 18(4):308-12. 1999.
[5]	Pincus, T., Burton, A.K., Vogel, S., Field, A.P., “A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain,” Spine, 27(5):E109-20. 2002.
[6]	Koyama, K., Nakazato, K., Min, S.K., Gushiken, K., Hatakeda, Y., Seo, K., Hiranuma, K., “Radiological abnormalities and low back pain in gymnasts. International journal of sports medicine,” 34(03): 218-22. 2013.
[7]	Tsuji, T., Matsuyama, Y., Sato, K., Hasegawa, Y., Yimin, Y., Iwata, H., “Epidemiology of low back pain in the elderly: correlation with lumbar lordosis,” J orthop Sci, 6(4):307-11. 2001.
[8]	Romero-Vargas, S., Zárate-Kalfópulos, B., Otero-Cámara, E., Rosales-Olivarez, L., Alpízar-Aguirre, A., Morales-Hernández, E., Reyes-Sánchez, A., “The impact of body mass index and central obesity on the spino-pelvic parameters: a correlation study,” European Spine Journal, 22(4):878-82. 2013.
[9]	Chen, Y.L., “Vertebral centroid measurement of lumbar lordosis compared with the Cobb technique,” Spine, 24(17):1786. 1999.
[10]	Chernukha, K.V., Daffner, R.H., Reigel, D.H., “Lumbar lordosis measurement: a new method versus Cobb technique,” Spine, 23(1):74-9. 1998.
[11]	Jackson, R.P., McManus, A.C., “Radiographic Analysis of Sagittal Plane Alignment and Balance in Standing Volunteers and Patients with Low Back Pain Matched for Age, Sex, and Size: A Prospective Controlled Clinical Study,” Spine, 19(14): 1611-8. 1994.
[12]	Murrie, V.L., Dixon, A.K., Hollingworth, W., Wilson, H., Doyle, T.A., “Lumbar lordosis: study of patients with and without low back pain,” Clin Anat, 16(2):144-7. 2003.
[13]	Vialle, R., Levassor, N., Rillardon, L., Templier, A., Skalli, W., Guigui, P., “Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects,” J bone Joint Surg Am, 87:260-207. 2005.
[14]	Nourbakhsh, M.R., Arab, A.M., “Relationship between mechanical factors and incidence of low back pain,” J Orthop Sports Phys Ther, 32(9):447-60. 2002.
[15]	Nikouei, A., Seddighi, A., Seddighi, A.S., “The Results of Image Guided Surgery Using Neuronavigation in Resection of Cerebral Gliomas in Eloquent Cortical Areas,” Arch Phys Med Rehabil, 97(10):e69-70. 2016.
[16]	Walker, M.L., Rothstein, J.M., Finucane, S.D., Lamb, R.L., “Relationships between lumbar lordosis, pelvic tilt and abdominal muscle performance,” Phys ther, 67:512-516. 1987.
[17]	Youdas, J.M., Garrett, T.R., Harmsen, S., Suman, V.J., Carey, J.R., “Lumbar lordosis and pelvic inclination in adults with chronic low back pain,” Phys ther, 80:261-275. 1996.
[18]	Horrison, D.D., Calliet, R., Janik, T.J., Troyanovich, S.J., Harrison, D.E., Holland, B., “Elliptical modeling of the sagittal lumbar lordosis and segmental rotation angles as a method to discriminate between normal and low back pain subjects,” J spinal Disord, 11:430-439. 1998.
[19]	Seddighi, A., Seddighi, A.S., Nikouei, A., Mohseni, G., “NS-06 IMAGE GUIDED SURGERY USING NEURONAVIGATION SYSTEM IN RESECTION OF CEREBRAL GLIOMAS INVOLVING ELOQUENT CORTICAL AREAS IN PEDIATRIC POPULATION,” Neuro-Oncology, 18(Suppl 3):iii128. 2016.
[20]	Jackson, R.P., Mc Manus, A.C., “Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex and size. A pros pective controlled clinical study,” Spine, 19:1611-1618. 1994.