Elliptical Modeling of the Sagittal Lumbar Lordosis and Segmental Rotation Angles as a Method to Discriminate Between Normal and Low Back Pain Subjects

Harrison, Donald D.; Cailliet, René; Janik, Tadeusz J.; Troyanovich, Stephan J.; Harrison, Deed E.; Holland, Burt

doi:10.1097/00002517-199810000-00010

Cited by 143 publications

(132 citation statements)

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“…4) (Schröder, Strübing & Mattes, 2010). These findings were in a line with earlier studies based on radiological methods or mathematical models, respectively (During et al, 1985;Harrison et al, 1998).…”

Section: Cross-sectional Findingssupporting

confidence: 93%

“…Some epidemiological reviews or radiographic cross-sectional and follow-up studies extracted frontal plane asymmetries and a flatter lumbosacral transition as anthropometric risk factors for the development and progredience of low back pain (Adams, Mannion & Dolan, 1999;Balagué, Troussier & Salminen, 1999;During et al, 1985;Harrison et al, 1998;Masset, Piette & Malchaire, 1998;Nissinen et al, 1994).…”

Section: Cross-sectional Findingsmentioning

confidence: 99%

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Spinal Alignment and Low Back Pain Indicating Spine Shape Parameters

Schroeder¹,

Klaus²

2012

Low Back Pain Pathogenesis and Treatment

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Section: Cross-sectional Findingssupporting

confidence: 93%

Section: Cross-sectional Findingsmentioning

confidence: 99%

Spinal Alignment and Low Back Pain Indicating Spine Shape Parameters

Schroeder¹,

Klaus²

2012

Low Back Pain Pathogenesis and Treatment

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“…Especially, frontal plane spinal asymmetries were identified to be a risk factor for low back pain syndromes [2]. When the most predictive factor for the development of low back pain-earlier back pain periods-could be controlled statistically, a flatter lumbar lordosis angle could be identified as a risk factor [1]; mathematical modeling studies reported a tendency for a flatter lordosis angle in chronic low back pain patients, too [11]. Some radiological findings in adults confirmed a flatter lumbar lordosis to be associated with chronic low back pain [13].…”

Section: Introductionmentioning

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

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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.

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“…Of interest, therefore, is the relationship between spinal posture, trunk-muscle activity, and the resultant stresses in the IVD. Indeed, during the past decade, an increasing number of radiographic studies have reported relationships between spine morphology (geometry, alignment and curvature) and lower back pain [7,10,16,17,43]. Other radiographic measurements may also have a relationship to lower back pain and disability.…”

Section: Introductionmentioning

confidence: 99%

Anterior thoracic posture increases thoracolumbar disc loading

Harrison¹,

Colloca

Harrison

et al. 2004

Eur Spine J

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In the absence of external forces, the largest contributor to intervertebral disc (IVD) loads and stresses is trunk muscular activity. The relationship between trunk posture, spine geometry, extensor muscle activity, and the loads and stresses acting on the IVD is not well understood. The objective of this study was to characterize changes in thoracolumbar disc loads and extensor muscle forces following anterior translation of the thoracic spine in the upright posture. Vertebral body geometries (C2 to S1) and the location of the femoral head and acetabulum centroids were obtained by digitizing lateral, full-spine radiographs of 13 men and five women volunteers without previous history of back pain. Two standing, lateral, fullspine radiographic views were obtained for each subject: a neutralposture lateral radiograph and a radiograph during anterior translation of the thorax relative to the pelvis (while keeping T1 aligned over T12). Extensor muscle loads, and compression and shear stresses acting on the IVDs, were calculated for each posture using a previously validated biomechanical model. Comparing vertebral centroids for the neutral posture to the anterior posture, subjects were able to anterior translate +101.5 mm±33.0 mm (C7-hip axis), +81.5 mm±39.2 mm (C7-S1) (vertebral centroid of C7 compared with a vertical line through the vertebral centroid of S1), and +58.9 mm±19.1 mm (T12-S1). In the anterior translated posture, disc loads and stresses were significantly increased for all levels below T9. Increases in IVD compressive loads and shear loads, and the corresponding stresses, were most marked at the L5-S1 level and L3-L4 level, respectively. The extensor muscle loads required to maintain static equilibrium in the upright posture increased from 147.2 N (mean, neutral posture) to 667.1 N (mean, translated posture) at L5-S1. Compressive loads on the anterior and posterior L5-S1 disc nearly doubled in the anterior translated posture. Anterior translation of the thorax resulted in significantly increased loads and stresses acting on the thoracolumbar spine. This posture is common in lumbar spinal disorders and could contribute to lumbar disc pathologies, progression of L5-S1 spondylolisthesis deformities, and poor outcomes after lumbar spine surgery. In conclusion, anterior trunk translation in the standing subject increases extensor muscle activity and loads and stresses acting on the intervertebral disc in the lower thoracic and lumbar regions.

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Elliptical Modeling of the Sagittal Lumbar Lordosis and Segmental Rotation Angles as a Method to Discriminate Between Normal and Low Back Pain Subjects

Cited by 143 publications

References 0 publications

Spinal Alignment and Low Back Pain Indicating Spine Shape Parameters

Spinal Alignment and Low Back Pain Indicating Spine Shape Parameters

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

Anterior thoracic posture increases thoracolumbar disc loading

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