Lumbar lordosis

Abstract

Lumbar lordosis is a key postural component that has interested both clinicians and researchers for many years. Despite its wide use in assessing postural abnormalities, there remain many unanswered questions regarding lumbar lordosis measurements. Therefore, in this article we reviewed different factors associated with the lordosis angle based on existing literature and determined normal values of lordosis. We reviewed more than 120 articles that measure and describe the different factors associated with the lumbar lordosis angle. Because of a variety of factors influencing the evaluation of lumbar lordosis such as how to position the patient and the number of vertebrae included in the calculation, we recommend establishing a uniform method of evaluating the lordosis angle. Based on our review, it seems that the optimal position for radiologic measurement of lordosis is standing with arms supported while shoulders are flexed at a 30° angle. There is evidence that many factors, such as age, gender, body mass index, ethnicity, and sport, may affect the lordosis angle, making it difficult to determine uniform normal values. Normal lordosis should be determined based on the specific characteristics of each individual; we therefore presented normal lordosis values for different groups/populations. There is also evidence that the lumbar lordosis angle is positively and significantly associated with spondylolysis and isthmic spondylolisthesis. However, no association has been found with other spinal degenerative features. Inconclusive evidence exists for association between lordosis and low back pain. Additional studies are needed to evaluate these associations. The optimal lordotic range remains unknown and may be related to a variety of individual factors such as weight, activity, muscular strength, and flexibility of the spine and lower extremities.

Effects of sex, age, body height and body weight on spinal loads: Sensitivity analyses in a subject-specific trunk musculoskeletal model

“…With no load in hands, the BW-normalized spinal loads further increase with BW in both sexes and particularly at higher BHs ( Due to the controversial relation between the lumbar lordosis and age, sex, BH and BW (or alternatively BMI) (Been and Kalichman, 2014), the initial (undeformed) lumbar lordosis was kept constant in all models. Some studies found no association between the lordosis and age (Kalichman et al, 2011;Murrie et al, 2003) while others reported age-related decrease (Amonoo-Kuofi, 1992) or increase (Tüzün et al, 1999) in the lordosis.…”

Epidemiology and Morphological Hallmark in Symptomatic Spondylotic Beninese Patients

“…Been had reported the existence of parameters such as age, sex, ethnicity and sport could affect the angle of LL [26]. Consequently lower LL in our spondylolisthesis population (with female dominancy) could be an imbalance compensation to reach a better sagittal balance of the spine body.…”

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

“…These results suggest that participants with TFA compensate for the limited hip motion by increasing anterior pelvic tilt and lumbar extension. Increased lumbar extension has been postulated to alter the mechanical loading of facet joints, thereby contributing to degenerative changes in the lumbar spine [49]. While conflicting evidence exists for lumbar extension as a contributing factor to LBP in the general population [49], such dynamic increase in lumbar motion during walking as a possible contributing factor to LBP warrants further research [35].…”

“…Increased lumbar extension has been postulated to alter the mechanical loading of facet joints, thereby contributing to degenerative changes in the lumbar spine [49]. While conflicting evidence exists for lumbar extension as a contributing factor to LBP in the general population [49], such dynamic increase in lumbar motion during walking as a possible contributing factor to LBP warrants further research [35]. Moderate evidence from the included studies also suggests increased trunk lateral flexion (p < 0.05) toward the amputated limb as compared with the intact limb during single-leg support phase [8][9]40,48].…”