The biomechanical function of the lumbosacral junction (LSJ) is obscure, but its medical significance is not, as it is the most common site of low back pain. In this study, we analyzed the difference between the mean values of the surface areas of the inferior body and total inferior facet areas of the fourth and fifth lumbar vertebrae. We aimed to define the function of the LSJ during weight transmission and clarify its mechanical significance. Vertebral columns of 45 adult male human cadavers from five anatomy departments in Nigeria were cut at the L3-L4 intervertebral disc and macerated. Using the graph paper method, the mean values of the surface area of the inferior body and total facet area of the fourth and fifth lumbar vertebrae were 1356 ± 26 and 329 ± 6 and 1277 ± 27 and 418 ± 8 mm, respectively. The relationships between the fourth and fifth lumbar vertebrae paired variables were highly significant (P < 0.001). A sudden reduction in the surface area of the inferior body of the fifth lumbar vertebra was compensated for by a corresponding increase in its total inferior facet area, which indicated that corresponding weight was diverted from the anterior column to the posterior column at the LSJ. This pattern of weight transmission may be a beneficial functional adaptation in man to protect the relatively large intervertebral disc of the LSJ in bipedal posture, or it may predispose the LSJ synovial zygapophyseal joints to mechanical stress.
The presence of the arches of the foot, especially the medial longitudinal arch shapes the foot to aid weight absorption and transmission of body weight during stance and dynamic positions. Absence of the medial longitudinal arch results to flat foot and this could be physiological (in children) or acquired. The present study, therefore, assessed the Planter Arch Indexes (PAI) and prevalence of flat foot in relation to occupation in Ikwo L. G. A of Ebonyi State, Nigeria. The study was carried out using a total sample size of 241 adult indigenes of Ikwo L. G. A. of Ebonyi state comprised of farmers (68 males and 72 females) and civil servants (male 56, female 45). The data were obtained through direct foot scans using HP photo scanner with scanning software. The data were analyzed using graph pad to obtain the mean, standard deviation, and paired t-test at 0.05 significant level. The result of the study showed among others, the mean values of normal male and female planter arch indexes of civil servants and farmers. The prevalence of flat foot revealed farmers 2.9% and civil servants, 3.3%, while the prevalence of right flat foot was 4.15% and left foot 2.5%. Male and female flat feet were also recorded as 3.7% and 2.5% respectively. The paired t test of the planter arch index and flat foot revealed not statistically significant both in gender and occupation, however, there was a statistical difference in female civil servant and farmers of 0.0022 at p< 0.05 significant levels. Based on the findings, the recommendations were forwarded to the clinicians, (specifically orthopedic surgeons), foot wear industries, students and academics for accessibility of information and further studies. In view of the results, the study concluded that there are no significant statistical differences in the variation of planter arch indexes and flat foot of the male and female civil servants and farmers in Ikwo L.G.A of Ebonyi State, Nigeria.
Purpose: The contribution of lumbosacral geometry to the development of spine anomalies is unclear. This study tested whether sacral base angle (SBA), lumbar gravity line position (GL) and patient height (HP) are associated with low back pain (LBP) and spondylolisthesis. The study aimed to determine the validity of SBA and GL in radiological evaluation and as factors that predisposes the lumbosacraAl junction (LSJ) to certain derangements. Materials and Methods: The prospective study involved 488 adult patients. Patients with non-injury related LBP (84) and those (46) without LBP; age range: 16-80 years were included. The remaining patients (358) with injury-related LBP were excluded. Digital images of antero-posterior and lateral views of the lumbosacral spine of the patients were blindly examined by two consultant radiologists. Pathologies were identified and classified according to age and sex. SBA and GL were determined using Ferguson's methods and height was measured using a health scale. Results: SBA (odds ratio: 1.045, P<0.05) and GL (odds ratio: 0.265, P<0.05) were significant factors predicting the development of LBP and spondylolisthesis, respectively. GL was found to be related to SBA (r=-0.409, p<0.01). Occurrence of LBP did not depend on age, sex, or HP. Discussion and Conclusion: SBA and GL are factors that should be considered when diagnosing noninjury related LBP and spondylolisthesis, respectively, as well as for correction of LSJ geometric distortion and when considering activities associated with transfer of large weights at the LSJ.
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