Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

Habibi, Zohreh; Maleki, Fatemeh; Meybodi, Ali Tayebi; Mahdavi, Atossa; Saberi, Hooshang

doi:10.4184/asj.2014.8.6.813

Cited by 30 publications

(26 citation statements)

References 22 publications

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“…A cross-sectional case–control study was designed by Habibi et al 36 in 2014 in order to evaluate the correlation between lumbosacral sagittal alignment and disc degeneration. They showed that the proposed global lumbosacral angle in the subject group was less than the control group, with the difference being statistically significant ( P = 0.002).…”

Section: Resultsmentioning

confidence: 99%

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

et al. 2016

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The purpose of this study is to determine the reliability and validity of a goniometric measurement of the vertical angle of the sacrum and sacral angle (SA), and their relationships to lumbar degeneration.A herniated lumbar disc is one of the most frequent medical issues. Investigators in a number of studies have reported associated risk factors for prevalent disc degeneration. Atypical lumbosacral angles and curvature are thought to contribute to the degradation of the spine by many researchers. This study analyzed 360 patients referred to our clinic from 2013 to 2015 due to low back pain. A cross-sectional case–control study was designed in order to compare the sagittal alignment of the lumbosacral area in 3 groups of patients suffering from LBP. A total 120 patients were in a control group with a normal lumbar magnetic resonance imaging (MRI), 120 patients had lumbar disk herniation (LDH), and 120 patients had spinal stenosis. From the sagittal plan of lumbar MRI, SA and vertical angle of sacral curvature (VASC) were determined and then analyzed.The means of VASC in these groups were: 38.98 (SD: 6.36 ± 0.58), 40.89 (SD: 7.69 ± 0.69), and 40.54 (SD: 7.13 ± 0.92), respectively (P = 0.089). Moreover, studies of SA in 3 groups showed that the means of SA were: 39.30 (SD: 6.69 ± 0.63), 40.52 (SD: 7.47 ± 0.65), and 35.63 (SD: 6.07 ± 0.79), respectively. Relation between SA and spinal stenosis was just statistically significant (P ≤ 0.05).One significant limitation of our study is the lack of standing MRI for increased accuracy of measurement. However, we were reluctant to give patients needless exposure to radiation from conventional X-ray, and instead used MRI scans. We did not find any significant correlation between the VASC and LDH in lumbar MRI. Also, SA is not an independent risk factor for LDH in men and women. We suggested that there are several biomechanical factors involved in LDH.

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Section: Resultsmentioning

confidence: 99%

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

et al. 2016

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“…17,34,35 In recent years the MRI has become "gold standard" in diagnostic of the numerous pathological conditions of lumbar spine, including lumbar spinal stenosis, due to its possibility to visualize Roentgen-negative soft tissues. Standing MRI which was the alternative method to standing X-ray was not available in our center, so we chose the method of supine MRI.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis

Макиров¹,

Yuz²,

Jahaf³

et al. 2015

Int J Spine Surg

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Goal of the study This study intends to develop a method of quantitative sagittal balance parameters assessment, based on a geometrical model of lumbar spine and sacrum. MethodsOne hundred eight patients were divided into 2 groups. In the experimental group have been included 59 patients with lumbar spinal stenosis on L1-5 level. Forty-nine healthy volunteers without history of any lumbar spine pathlogy were included in the control group. All patients have been examined with supine MRI. Lumbar lordosis has been adopted as circular arc and described either anatomical (lumbar lordosis angle), or geometrical (chord length, circle segment height, the central angle, circle radius) parameters. Moreover, 2 sacral parameters have been assessed for all patients: sacral slope and sacral deviation angle. Both parameters characterize sacrum disposition in horizontal and vertical axis respectively. ResultsSignificant correlation was observed between anatomical and geometrical lumbo-sacral parameters. Significant differences between stenosis group and control group were observed in the value of the "central angle" and "sacral deviation" parameters. We propose additional parameters: lumbar coefficient, as ratio of the lordosis angle to the segmental angle (Kl); sacral coefficient, as ratio of the sacral tilt (ST) to the sacral deviation (SD) angle (Ks); and assessment modulus of the mathematical difference between sacral and lumbar coefficients has been used for determining lumbosacral balance (LSB). Statistically significant differences between main and control group have been obtained for all described coefficients (p = 0.006, p = 0.0001, p = 0.0001, accordingly). Median of LSB value of was 0.18 and 0.34 for stenosis and control groups, accordingly. ConclusionBased on these results we believe that that spinal stenosis is associated with an acquired deformity that is measureable by the described parameters. It's possible that spinal stenosis occurs in patients with an LSB of 0.2 or less, so this value can be predictable for its development. It may suggest that spinal stenosis is more likely to occur in patients with the spinal curvature of this type because of abnormal distribution of the spine loads. This fact may have prognostic significance for develop vertebral column disease and evaluation of treatment results.keywords: sagittal lumbosacral balance, lumbar lordosis, lordosis angle, lumbosacral sagittal alignment volume 9 article 68

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“…Hresko et al (2) stated that a high mean PI (78.9° (standard deviation (SD) 12.1°)) was noted in patients with high-grade spondylolisthesis. An association between abnormal sagittal alignment and LBP was also established (13,14).…”

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confidence: 88%

Spino-pelvic alignment, balance, and functional disability in patients with low-grade degenerative lumbar spondylolisthesis

Chuang¹,

Liaw²,

Wang³

et al. 2018

J Rehabil Med

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Low-grade degenerative lumbar spondylolisthesis (DLS) is defined as less than 50% slippage of a lumbar vertebral body over the next most caudal vertebral body. Patients with DLS usually experience back pain, leg pain, and even falls.The pain intensity, static and dynamic balance, functional disability, and the spino-pelvic parameters of the radiography (pelvic incident, pelvis tilt, sacral slope, lumbar lordosis) were compared between the patients with DLS and without DLS (non-DLS).The results revealed that DLS patients were older, had greater angle of pelvic incidence and pelvic tilt, less stability and more low back pain than non-DLS patients.The pelvic tilt was the major compensating factor of spino-pelvic balance in both groups. Lumbar lordosis is positively related to body mass index. Sacral slope and lumbar lordosis contributed to partial compensation of balance of spinopelvic alignment in DLS patients, whereas sacral slope could be an indicator of fall risk in non-DLS patients. Objective: To evaluate the relationships among spino-pelvic parameters, trunk balance and functional disability in patients with degenerative lumbar spondylolisthesis. Design: Cross-sectional study. Subjects: Forty-five patients with degenerative lumbar spondylolisthesis and 32 patients without degenerative lumbar spondylolisthesis. Methods: Spino-pelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) and pain severity were evaluated. Biodex balance tests (postural stability, limits of stability, modified clinical test of sensory interaction and balance, fall risk) and Quebec Back Pain Disability Scale (QBDS) scores were measured. Results: Intergroup differences were found in age, low back pain, limits of stability, pelvic incidence, pelvic tilt and some subscales of QBDS. Correlations were found: (i) in the degenerative lumbar spondylolisthesis group: between pelvic incidence and sacral slope/pelvic tilt/lumbar lordosis/height/limits of stability; sacral slope and lumbar lordosis/height/ limits of stability/modified clinical test of sensory interaction and balance (eyes closed on foam); lumbar lordosis and body mass index/QBDS/postural stability/modified clinical test of sensory interaction and balance (eyes open and eyes closed on foam); (ii) in the non-degenerative lumbar spondylolisthesis group: between pelvic incidence and pelvic tilt; pelvic tilt and sacral slope/lumbar lordosis; sacral slope and lumbar lordosis/fall risk. All spino-pelvic parameters in the degenerative lumbar spondylolisthesis group and pelvic tilt in the non-degenerative lumbar spondylolisthesis group correlated with QBDS. Conclusion: Pelvic tilt was the major compensating factor in both groups (patients with and without degenerative lumbar spondylolisthesis). Sacral slope and lumbar lordosis contributed to partial compensation in the degenerative lumbar spondylolisthesis group. Lumbar lordosis correlated with body mass index. Sacral slope could be an indicator of fall risk in the non-degenerative lumbar spondylolisthesis group.

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Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

Cited by 30 publications

References 22 publications

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis

Spino-pelvic alignment, balance, and functional disability in patients with low-grade degenerative lumbar spondylolisthesis

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