Classification of Sagittal Thoraco-Lumbo-Pelvic Alignment of the Adolescent Spine in Standing and Its Relationship to Low Back Pain

Smith, Anne; O’Sullivan, Peter; Straker, Leon

doi:10.1097/brs.0b013e31817ec3b0

Cited by 170 publications

(175 citation statements)

References 38 publications

Supporting

Mentioning

153

Contrasting

Unclassified

Order By: Relevance

“…In support of this view a study investigating sagittal standing posture by Smith et al (2008) in 14 year olds highlighted that some postural sub-groups carry an increased risk for LBP. It was suggested that some of these postural changes may be influenced by developmental and/or genetic factors, or as a response to patterns of loading such as increased BMI, and carry a greater risk for LBP.…”

Section: What Drives the Altered Motor Control?mentioning

confidence: 89%

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Dankaerts

O’Sullivan

2011

Manual Therapy

View full text Add to dashboard Cite

a b s t r a c tChronic Low Back Pain (LBP) remains a common, recalcitrant and costly problem for the individual sufferer and for society. Effective treatments that reduce the social and economic burden have yet to be established for the majority of chronic LBP cases. Lack of evidence for specific interventions has been blamed on the heterogeneity of the chronic LBP population as well as a lack of a patient centred biopsycho-social approach. This issue of heterogeneity has resulted in classification being considered the highest research priority in the area of chronic LBP. The potential for a 'wash-out effect' caused by the heterogeneity of the chronic LBP populations sampled for randomised controlled clinical trials (RCTs), has driven the need for classifying patients with nonspecific chronic LBP. A summary of a series of studies is outlined in this review paper. They represent a comprehensive investigation into the validity of O'Sullivan's proposed mechanism-based classification system (CS) for a sub-group of localized mechanically provoked nonspecific chronic LBP with motor control impairment (MCI). Further, the findings of these studies are discussed in relation to the relevant literature and the clinical implications arising are presented. Finally, the limitations of this research are outlined and recommendations for future research are made.

show abstract

Section: What Drives the Altered Motor Control?mentioning

confidence: 89%

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Dankaerts

O’Sullivan

2011

Manual Therapy

View full text Add to dashboard Cite

show abstract

“…On the other hand, there might be an assessment-related influence, especially affecting our results of lumbar lordosis angles. Recent research, using Table 5 Descriptions and results of a 1-way ANOVA for the subsamples of the controls (n = 192) and the LBP patients under 40 (n = 58) and over 40 years of age (n = 155) and separately in the lumbar lordosis angle for males (CON n = 113, LBP under 40 n = 27, LBP over 40 n = 57) and females (CON n = 79, LBP under 40 n = 31, LBP over 40 n = 98) lateral photography with manually placed markers on bony structures and no X-ray imaging, revealed a more neutral sagittal curvature as being correlated with less pain [23]. Maybe, interindividually varying soft tissue thicknessespecially fat and muscles in the lumbar back regionpartially covered specific bony spinal alignment patterns in the indirect spine shape reconstruction based on surface topography, although rasterstereography was validated in terms of X-ray comparisons [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Spinal alignment in low back pain patients and age-related side effects: a multivariate cross-sectional analysis of video rasterstereography back shape reconstruction data

2013

View full text Add to dashboard Cite

Purpose Spinal form in the sagittal plane and asymmetries of spinal alignment in the frontal plane were identified earlier to be associated with low back pain. This study was aiming at investigating whether age was influencing the significance of these findings. Methods Spinal alignment of 155 older and 58 younger low back pain patients was investigated using non-invasive video rasterstereography and compared to 192 pain free controls. Trunk inclination and imbalance, pelvis tilt and torsion, and the thoracic kyphosis and lumbar lordosis angle served as dependent variables, which were analyzed using multivariate procedures. Results Frontal plane parameters-trunk imbalance (k [ 0.60) in combination with pelvis tilt (k [ 0.64)-constituted an independent component in a factor analysis model of spine shape parameters in younger and older patients, but not in pain free controls. Trunk imbalance (frontal), trunk inclination (sagittal) and partially thoracic kyphosis angle (sagittal) were extracted to separate patients from controls (discriminant coefficients [0.50). Age could not be excluded as interfering variable for the lumbar lordosis angle. Significant univariate analyses revealed higher effect sizes for trunk imbalance and inclination (g 2 [ 0.07) than for lordosis, kyphosis or pelvic parameters (g 2 \ 0.06). Conclusions In line with corresponding findings trunk imbalance remained a low back pain-associated parameter not depending on age. Over all, sagittal trunk inclination and the thoracic kyphosis angle could not be established as being completely free from age influences, while the lumbar lordosis angle played a minor role and seemed to be influenced more by age than by low back pain in this rasterstereography study.

show abstract

“…A reliable imaging procedure of spinal alignment may offer classification models of spinal form variations leading to different therapy options [2,3], or might be used for therapy monitoring, as well [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…lateral photometric imaging [3,8], or electro-mechanical inclinometers for back surface reconstruction, e.g. Spinal Mouse [9], or three-dimensional raster stereography back shape reconstruction devices with a minimised examiner's influence due to the optical, non-contact character of measurement needing no markers or detectors on the skin surface [10].…”

Section: Introductionmentioning

confidence: 99%

Video raster stereography back shape reconstruction: a reliability study for sagittal, frontal, and transversal plane parameters

2014

View full text Add to dashboard Cite

Purpose As reliability of raster stereography was proved only for sagittal plane parameters with repeated measures on the same day, the present study was aiming at investigating variability and reliability of back shape reconstruction for all dimensions (sagittal, frontal, transversal) and for different intervals. Methods For a sample of 20 healthy volunteers, intraindividual variability (SEM and CV %) and reliability (ICC ± 95 % CI) were proved for sagittal (thoracic kyphosis, lumbar lordosis, pelvis tilt angle, and trunk inclination), frontal (pelvis torsion, pelvis and trunk imbalance, vertebral side deviation, and scoliosis angle), transversal (vertebral rotation), and functional (hyperextension) spine shape reconstruction parameters for different test-retest intervals (on the same day, between-day, between-week) by means of video raster stereography. Results Reliability was high for the sagittal plane (pelvis tilt, kyphosis and lordosis angle, and trunk inclination: ICC [ 0.90), and good to high for lumbar mobility (0.86 \ ICC \ 0.97). Apart from sagittal plane spinal alignment, there was a lack of certainty for a high reproducibility indicated by wider ICC confidence intervals. So, reliability was fair to high for vertebral side deviation and the scoliosis angle (0.71 \ ICC \ 0.95), and poor to good for vertebral rotation values as well as for frontal plane upper body and pelvis position parameters (0.65 \ ICC \ 0.92). Coefficients for the between-day and between-week interval were a little lower than for repeated measures on the same day. Variability (SEM) was less than 1.5°or 1.5 mm, except for trunk inclination. Relative variability (CV) was greater in global trunk position and pelvis parameters (35-98 %) than in scoliosis (14-20 %) or sagittal sway parameters (4-8 %). Conclusions Although we found a lower reproducibility for the frontal plane, raster stereography is considered to be a reliable method for the non-invasive, three-dimensional assessment of spinal alignment in normal non-scoliotic individuals in the sagittal plane and partly for scoliosis parameters, which fulfils scientific as well as practical recommendations for spine shape screening and monitoring, but cross-sectional or follow-up effect analyses should take into account the degree of reliability differing in various spine shape parameters. Further investigations should be conducted to analyse reliability in scoliosis patients with differing spinal deformities.

show abstract

Classification of Sagittal Thoraco-Lumbo-Pelvic Alignment of the Adolescent Spine in Standing and Its Relationship to Low Back Pain

Abstract: Meaningful classifications exist for adolescent sagittal thoraco-lumbo-pelvic alignment, and these can be determined successfully from sagittal photographs. More neutral thoraco-lumbo-pelvic postures are associated with less back pain.

Cited by 170 publications

References 38 publications

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Spinal alignment in low back pain patients and age-related side effects: a multivariate cross-sectional analysis of video rasterstereography back shape reconstruction data

Video raster stereography back shape reconstruction: a reliability study for sagittal, frontal, and transversal plane parameters

Contact Info

Product

Resources

About