Lumbar lordosis: Study of patients with and without low back pain

Murrie, Vanessa; Dixon, A K; Hollingworth, William; Wilson, Hannah; Doyle, Terence

doi:10.1002/ca.10114

Cited by 77 publications

(78 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Overall, our findings for the cervical spine appear to mirror the majority of those reported for the lumbar spine: whilst there is some suggestion that individuals with a flatter spine (reduced lordosis) have a slightly higher risk of developing low back pain [1], the vast majority of cross-sectional studies conclude that there is no significant difference in the degree of lordosis in people with and without back pain [20,36,39].…”

Section: Discussionsupporting

confidence: 76%

The association between cervical spine curvature and neck pain

2006

View full text Add to dashboard Cite

Degenerative changes of the cervical spine are commonly accompanied by a reduction or loss of the segmental or global lordosis, and are often considered to be a cause of neck pain. Nonetheless, such changes may also remain clinically silent. The aim of this study was to examine the correlation between the presence of neck pain and alterations of the normal cervical lordosis in people aged over 45 years. One hundred and seven volunteers, who were otherwise undergoing treatment for lower extremity problems in our hospital, took part. Sagittal radiographs of the cervical spine were taken and a questionnaire was completed, enquiring about neck pain and disability in the last 12 months. Based on the latter, subjects were divided into a group with neck pain (N = 54) and a group without neck pain (N = 53). The global curvature of the cervical spine (C2-C7) and each segmental angle were measured from the radiographs, using the posterior tangent method, and examined in relation to neck complaints. No significant difference between the two groups could be found in relation to the global curvature, the segmental angles, or the incidence of straight-spine or kyphotic deformity (P > 0.05). Twenty-three per cent of the people with neck pain and 17% of those without neck pain showed a segmental kyphosis deformity of more than 4°in at least one segment-most frequently at C4/5, closely followed by C5/6 and C3/4. The average segmental angle at the kyphotic level was 6.5°in the pain group and 6.3°i n the group without pain, with a range of 5-10°in each group. In the group with neck pain, there was no association between any of the clinical characteristics (duration, frequency, intensity of pain; radiating pain; sensory/motor disturbances; disability; healthcare utilisation) and either global cervical curvature or segmental angles. The presence of such structural abnormalities in the patient with neck pain must be considered coincidental, i.e. not necessarily indicative of the cause of pain. This should be given due consideration in the differential diagnosis of patients with neck pain.

show abstract

Section: Discussionsupporting

confidence: 76%

The association between cervical spine curvature and neck pain

2006

View full text Add to dashboard Cite

show abstract

“…126 Several other studies have observed the degree of standing lumbar lordosis in the female spine to be 26%-28% greater than the male spine; 30,139,210 however, no information was provided on the parous history of those females. Interestingly, changes in mass distribution in the body due to increased body mass index showed little 85,137 or no effect on lumbar lordosis in males or females.…”

Section: Sexual Dimorphism and The Lumbar Spinementioning

confidence: 95%

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration

Sparrey

Bailey

Safaee

et al. 2014

FOC

View full text Add to dashboard Cite

The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.

show abstract

“…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. In a preliminary study (not reported here) simulating forward flexion, however, the initial L1-S1 lordosis Cobb's angle was increased by 10 o (from 46 o ) while preserving the kyphosis angle and the sacral plumb line in agreement with the literature (Endo et al, 2010;Jackson et al, 1998;Park et al, 2013).…”

Section: Interpretationsmentioning

confidence: 99%

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

Ghezelbash

Shirazi‐Adl

Arjmand

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

Five symmetric sagittal loading conditions were considered, and main effect plots and analyses of variance were employed to identify influential parameters. In all 5 tasks simulated, BW (98.9% in compression and 96.1% in shear) had the greatest effect on spinal loads at the L4-L5 and L5-S1 levels followed by sex (0.7% in compression and 2.1% in shear), BH (0.4% in compression and 1.5% in shear) and finally age (<5.4%). At identical BH and BW, spinal loads in females were slightly greater than those in males by ~4.7% in compression and ~8.7% in shear. In tasks with no loads in hands, BW-normalized spinal loads further increased with BW highlighting the exponential increase in spinal loads with BW that indicates the greater risk of back disorders especially in obese individuals. Uneven distribution of weight in obese subjects, with more 17 BW placed at the lower trunk, further (though slightly <7.5%) increased spinal loads.

show abstract

Lumbar lordosis: Study of patients with and without low back pain

Cited by 77 publications

References 14 publications

The association between cervical spine curvature and neck pain

The association between cervical spine curvature and neck pain

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration

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

Contact Info

Product

Resources

About