Radiographic analysis of the lumbar and sacral region angles in young Turkish adults

Neurosciences (Riyadh, Saudi Arabia), 2007

To understand the normal lumbar spine in the sagittal plane, and the range of lumbar lordosis. This study was carried out in the Department of Anatomy, School of Medicine, Duzce University, Duzce, Turkey in the year 2005. We retrospectively reviewed T1-weighed sagittal spin-echo MRIs of the lumbar spine in 413 individuals (188 male, 225 female) aged between 13-82 years, and evaluated the angle of lumbar lordosis (ALL), sacrohorizontal angle (SHA), and lumbosacral angle (LSA). The ALL and SHA were significantly greater in females than in males (p<0.05). Weak, but significant correlations were detected between age and ALL, SHA, and LSA for females (p<0.05). The LSA was significantly greater for individuals over 41 years (p<0.05) when the entire study group was considered, and it was also significantly greater for individuals over 51 years in females (p<0.05). The LSA was significantly greater in the 7th decade than in the 3rd decade (p<0.05). The results of this study p...

INTRODUCTION The vertebral spine presents regional curves on sagittal plane designed to absorb impact, reduce its longitudinal stiffness and intensify muscular function. 1 Values of sagittal curve measurements of the spine present great variability in normal individuals often with a wide range of variation. The lumbosacral region is the most important region in the vertebral column in terms of mobility and weight bearing. The vertebral column is lordotic in the cervical and lumbar regions and kyphotic in the thoracic and sacral vertebrae. The human lumbar vertebrae support the weight of the upper body. It is the main load-bearing region of the entire vertebral column and its abnormality contributes to the development of an array of pathological symptoms such as low back pain. The geometric angles of the lumbosacral spine (lumbar angles) are of clinical importance. The correlation between lumbar angles and the incidence of low back pain has been described. 2-4 The shape and geometry of the lumbosacral spine has been reported to be of importance in the occurrence of low back pain. 5-7 The sacral inclination also has a considerable clinical significance. As a result of the sacral inclination, an individual maintains an erect posture by developing a lordotic curve in the lumbar spine in order to compensate for the angulations of the sacrum. 7,8 There is paucity of data on normal values of lumbar lordosis angle for the Nigerian population. Consequently, values that constitute hypo-/hyper-lordosis in clinical practice are based on studies from other races. ABSTRACT Background: There is paucity of data on the geometric angles of the lumbosacral spine in Nigeria and other African countries. The objective was to study the lumbar angles in our population and causes of variations if any. Methods: The lateral views of the lumbosacral spine radiographs of 300 Nigerian subjects were studied. The lumbar angles measured were lumbosacral angle (LSA), Lumbar lordosis angle (LLA), Sacral inclination angle (SIA) and lumbosacral disc angle (LSDA). The demographics and anthropometric measurements of the subjects such as weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC) and waist-hip ratio (WHR) were also recorded. Results: The mean values of the angles were as follows: LSA=37.8 0 ±9.2 0 ; LLA=40.4 0 ±11.2 0 ; SIA=38.7 0 ±8.9 0 and LSDA=14.6 0 ±3.4 0. There was a positive correlation between the weight, BMI, HC and WC of the subjects and LSA. A significant association was noted between the height, weight, BMI, HC, WC and WHR of the subjects and LLA. Whereas SIA was significantly affected by sex, weight, BMI, HC and WC of the subjects, LSDA was determined by age, BMI, WC and WHR. Conclusion: The mean values of these angles may form the reference values for the Nigerian population. Overweight and obesity were associated with increased lumbar angles.

Orthopedic Reviews, 2012

Low back pain (LBP) is the most common health problem. Many factors have been demonstrated to be fundamental risk factors of LBP such as body mass index (BMI), age and sex. However, so far there have been few studies demonstrating the association between lumbo-pelvic alignment (LPA) and these factors. This present study was aimed to clarify the correlation between the LPA and the risk factors contributing to LBP. Standing lateral Xrays were taken from 100 healthy volunteers (70 males and 30 females) with no history of low back pain before their participation. Average age of subjects was 33.3±6.8 years (rang 21-50). Mean body weight was 59.1±7.9kg (range 40-82), mean body height was 163.6±7.2 cm (range 145-178) and mean BMI was 22.1±2.4 kg/m 2 (range 18.0-29.3). The LPA was classified into 3 types according to the recently proposed pelvic orientation guidelines. No direct correlation was found between the pelvic orientation and age or BMI. Each LPA type was associated with sex but not BMI and age (P=0.00, 0.71, and 0.36, respectively). The results from this study demonstrated the differences in LPA between male and female, and also confirmed that the sagittal orientation of the pelvis remained constant in adults. The high prevalence of LPA type 1 in males may reduce the occurrence of LBP in obese male individuals.

Journal of Turkish Spinal Surgery, 2021

Objective: Normal values of sagittal vertebral, pelvis and global spinopelvic parameters have been reported to vary from society to society. The aim of this study was to determine these parameters in a young adult Turkish population and to evaluate the relationship between the sagittal spinopelvic measurements. This was the first study on this subject in a Turkish population. Materials and Methods: The study included a total of 170 subjects comprising 137 (80.6%) males and 33 (19.4%) females, with a mean age of 24.1±4.9 years. Anteroposterior and lateral spine X-rays and pelvis X-rays were performed to evaluate the sagittal vertebral, pelvis and global spinopelvic parameters. Patients were classified according to the Roussouly classification system to classify normal variations of the vertebrae, pelvis and sacrum in the sagittal plane. Normal distribution of the variables was examined with the Shapiro-Wilk test. The Independent Samples t-test was used in the comparison of mean values.

European Spine Journal, 2011

The analysis of the sagittal balance is important for the understanding of the lumbopelvic biomechanics. Results from previous studies documented the correlation between sacro-pelvic orientation and lumbar lordosis and a uniqueness of spino-pelvic alignment in an individual person. This study was subjected to determine the lumbopelvic orientation using pelvic radius measurement technique. The standing lateral radiographs in a standardized standing position were taken from 100 healthy volunteers. The measurements which included hip axis (HA), pelvic radius (PR), pelvic angle (PA), pelvic morphology (PR-S1), sacral translation distance (HA-S1), total lumbosacral lordosis (T12-S1), total lumbopelvic lordosis (PR-T12) and regional lumbopelvic lordosis angles (PR-L2, PR-L4 and PR-L5) were carried out with two independent observers. The relationships between the parameters were as follows. PR-S1 demonstrated positive correlation to regional lumbopelvic lordosis and revealed negative correlation to T12-S1. PA showed negative correlation to PR-S1 and regional lumbopelvic lordosis, but revealed positive correlation to HA-S1. T12-S1 was significantly increased when PR-S1 was lesser than average (35°-45°) and was significantly decreased when PR-S1 was above the average. PR-L4 and PR-L5 were significantly reduced when PR-S1 was smaller than average and only PR-L5 was significantly increased when PR-S1 was above the average. In conclusion, this present study supports that lumbar spine and pelvis work together in order to maintain lumbopelvic balance.

Changes in posture is among the risk factors of low back pain. The shape of the lumbar spine is influenced in a way by a strain on tendons and muscles because of abnormal posture. Little is known about what the nominal value of key radiologic angles for the Ghanaian populace is and accordingly, what comprises hypo-/hyper-lordosis. The Lumbar Lordotic Angle (LSA) and Lumbosacral Angle (LSA) are potential angles, for the examination of low back issues, in addition to treatment and diagnosis. The study was intended to measure LLA and LSA of this populace using the local data. A retrospective methodology was adopted to gather typical laterally prostrate lumbosacral radiographs of 140 subjects (15 years or more) in a recumbent position. Results: The normal LLA values varied between 20.90 to 68.00 with the mean (standard deviation) of 35.9 (9.82)° and there exist a significant difference with sex but insignificant variations among the age categories comparable to a number of the literatur...

Surgical and Radiologic Anatomy, 2003

Pedicle screw fixation of the spine has become one of the most stable and versatile methods of spine fixation, and knowledge of pedicle morphology is crucial for the safe application of these systems. We undertook this study because only a few reports have investigated Eastern populations. Lumbar pedicle anatomy, i.e., pedicle width (PW) and pedicle height (PH), transverse and sagittal pedicle angles (TPA, SPA), and pedicle length (PL), were assessed in the following two groups: (1) computed tomography scans of 29 normal adults, and (2) 16 dried lumbar spines obtained from the Anatomy Department. Interpedicular distance was different in each group. PW ranged from 4 mm to 14 mm. In both groups, the narrowest PH was 8.2 mm, the widest 19.7 mm. TPA ranged from 6 o to 19 o and increased from L1 to L5. In the sagittal plane, the pedicles angled caudally at L5. PL was longest at L1 and shortest at L5. In conclusion, pedicle dimensions and angles may show individual and structural differences. Our data were not significantly different from previous reported data. A detailed knowledge of these relationships is important for any surgery involving screw purchase via a pedicle, to prevent screw cutout and failure of fixation or neurological injury. Selection of the proper diameter of screw

Fisioterapia e Pesquisa, 2016

The literature about posture in older adults includes studies that measure spine angles through several strategies. This may interfere with postural diagnosis and impact on the resolution of comorbidities affecting the spine in older people. The objective of this study was to compare two lumbar spine measurement methods commonly used in research. The association between these measures and the angle of kyphosis was used as the basis for comparison. One hundred-sixty older adults were submitted to anteriorposterior lumbar spine x-ray. Two Cobb measures were used for each image (L1-L5 and L1-S1) and the conventional measure for hyperkyphosis. Only the measure based on L1-L5 was associated with the kyphosis angle. The study suggests that lumbar spine x-rays should be analyzed through the L1-L5 Cobb strategy in older people.

The purpose of this descriptive study was to standardize the normal values of lumbar vertebral Cobb's angle for Sudanese subjects using Computerized Tomography (CT).This study was obtained at Al-Zytouna specialized hospital and Royal Care hospital. A sample of 200 Sudanese patients with different ages and genders were included. Cobb's method was used in the evaluation of superior and inferior lumbar vertebra end plates. The lateral scouts for lumbar spine were obtained. Traumatic cases and any disease of the vertebral column, spinal canal, para vertebral muscles were excluded. Toshiba CT scanner was used. The exposure factors were 120 KVp, 10-50 MA. End plates angle from L1 to L5 were measured using Cobb's method for both genders and the data were correlated to their ages, and body mass index (BMI). The mean Cobb's angle of lumbar vertebral in males was (30.59 0) and in females was (35.65 0).There is significant differences in Cobb's angle of lumbar spine between the two genders at p=0.000. The mean BMI in males was (24.53) and in females was (25.79),There is a linear relationship between Cobb's angle of the lumbar vertebral and BMI. The study concluded that the mean Cobb's angle of lumbar vertebral differs significantly between genders in Sudanese.

2015

This study compared the upper and lower lumbar angles of normal body mass index and overweight young adults, and examined the relationships among body mass index, waist circumferences, and lumbar angles. [Subjects and Methods] Sixty participants aged 18-25 years were recruited and allocated to 2 groups (n=30 per group): normal body mass index (18.5-24.9 kg/m 2) and overweight group (body mass index, ≥ 25.0 kg/ m 2). During lumbar angle measurement, the participants stood in a relaxed position with bare feet. The upper and lower lumbar angles of each participant were measured using a flexible ruler, and the angle calculated by the tangent method. The waist circumference was also measured. [Results] The mean lower lumbar angle in the overweight group was significantly greater than that of the normal body weight group. Moreover, only the lower lumbar angle was associated with a significant increase in the body mass index (r= 0.28). Waist circumference showed no association with the lumbar angles. [Conclusion] This is the first study to suggest that increased body weight could cause lower lumbar angle deviation in young adults. Further studies should investigate individuals with symptomatic back pain or back dysfunction and the impact of body weight on lumbar spinal angles.