Pelvic Incidence and Lumbar Spine Instability Correlations in Patients with Chronic Low Back Pain

Golbakhsh, Mohammadreza; Hamidi, Majid Attar; Hassanmirzaei, Bahar

doi:10.5812/asjsm.34554

Cited by 9 publications

(8 citation statements)

References 32 publications

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“…Both the parameters were found to be highest at the L4-L5 segment. These findings are in accordance with Golbakhsh et al [ 20 ] who evaluated translations and angulations for each level separately in their study of correlation between pelvic incidence and lumbar instability. They observed most translations and angulations occur at L4-L5 level followed by L3-L4 level.…”

Section: Discussionsupporting

confidence: 92%

Radiographic Incidence of Lumbar Spinal Instability in Patients with Non-spondylolisthetic Low Backache

Rathod

Dhake

2018

Cureus

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IntroductionRadiological lumbar spinal instability may exist without obvious spondylolisthesis. We aim to determine the incidence of this non-spondylolisthetic cause of instability in conservatively managed patients and operated groups of patients. We also attempted to study the relationship between instability and its occurrence with respect to age, sex, signs and symptoms.Materials and methodsTwenty-three patients treated conservatively (group A) for non-spondylolisthetic backache were studied for radiological evidence of instability by evaluating angular rotation and sagittal translation at each lumbar motion segment. The influence of age, sex, signs and symptoms on the occurrence of instability was studied. A total of 18 patients treated surgically (group B) for non-spondylolisthetic backache in the form of discectomy/decompression were evaluated for occurrence of instability at three months, six months and nine months postoperatively.ResultsFour out of 23 patients (17.4%) in group A had radiological instability. Angular rotation was found to have negative correlation with age, while sagittal translation did not show any consistent correlation with age. Neither had any significant correlation with sex. The incidence of instability in patients treated with discectomy at three months and six months was 20% which reduced to 10% at nine months while that in patients treated with decompression was about 37.5% over three months, six months and nine months of follow-up.ConclusionIf patients with spondylolisthesis were excluded from the study, instability could still result from the rotational component in sagittal plane. Secondary iatrogenic instabilities do result in patients undergoing extensive decompression for spinal stenosis and should always be thought of.

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Section: Discussionsupporting

confidence: 92%

Radiographic Incidence of Lumbar Spinal Instability in Patients with Non-spondylolisthetic Low Backache

Rathod

Dhake

2018

Cureus

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“…This result is in line with previous studies which have used similar radiographic assessment techniques, where the L4-L5 and L3-L4 vertebral levels have been shown to demonstrate the highest amounts of mean angular rotation and sagittal translation. The lack of increased mean angular rotation and sagittal translation observed at the L5-S1 vertebral level on flexion/extension X-rays is also in line with the results of other studies (Golbakhsh et al, 2012;Rathod & Dhake, 2018), despite L5-S1 being a common location of disc degeneration. A recent kinematic MRI study showed that intervertebral disc disease was most common at this level (Roberts et al, 2021) and changes in the morphology of the MF muscle have also been most commonly observed at this vertebral level (Goubert et al, 2016;Wallwork et al, 2009).…”

Section: Discussionsupporting

confidence: 91%

Relationship between the morphology and composition of the lumbar paraspinal and psoas muscles and lumbar intervertebral motion in chronic low‐back pain: An exploratory study

et al. 2022

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Muscles of the lumbar spine play an important role in controlling segmental intervertebral motion. This study aimed to evaluate the association between lumbar intervertebral motion and changes in lumbar morphology/composition in people with chronic low-back pain (CLBP). A sample of 183 patients with CLBP participated in this cross-sectional study. Participants underwent lumbar flexion-extension X-rays to determine vertebral motion (translational and/or rotational motion) of lumbar levels (L1-L2 to L5-S1) and lumbar spine magnetic resonance imaging to quantify total and functional cross-sectional areas (CSAs) and asymmetry of the multifidus (MF), lumbar erector spinae (LES), and psoas muscles. The relationship between morphology/ composition of the muscles and lumbar intervertebral motion was investigated. Smaller total and functional CSAs of the MF and greater CSAs of the LES muscle were observed in participants with greater intervertebral motion. Muscle asymmetry was observed at different lumbar vertebral levels. The greatest amount of translational intervertebral motion was observed at the L3-L4 level, while the greatest amount of rotational translation occurred at the L4-L5. Associations were observed between the morphology of the paraspinal muscles at the vertebral levels adjacent to the L3-L4 level and the increased intervertebral motion at this level. Relationships between measures of muscle morphology/composition and increased segmental vertebral motion were observed. The results may provide a plausible biological reason for the effectiveness of rehabilitating deficient paraspinal muscles in a subset of people with CLBP.

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“…Another clinical study confirmed that PI was significant different in patients with high-grade spondylolisthesis versus those with low-grade spondylolisthesis, and it also had a significant correlation with the dislocation level in all patients [14]. The relationship between the PI and chronic low back pain was explored by enrolling 52 patients with chronic low back pain in a case-control study, showing that PI did not differ between the LBP and control groups, but a separate evaluation of each level revealed lumbar instability of L5-S1 segment was associated with lower PI [15]. The relationship between PI and spinal degenerative disease warrants further research.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Relationship Between Modic Change and Spinopelvic Parameters in the Sagittal Plane

Lian

et al. 2020

Med Sci Monit

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Departmental sources Background: This study explored relationship between Modic change and spinopelvic parameters in the sagittal plane. Material/Methods: We divided 80 patients into 4 groups: 60 subjects diagnosed with Modic changes (MC) were enrolled in the MC groups (MC1, MC2, and MC3) with each MC type consisting of 20 subjects, and 60 healthy subjects were enrolled in the control group. Spinopelvic parameters in the sagittal plane were calculated to assess their associations with MC. Multivariate logistic regression was used to explore possible risk factors for MC. Results: PI and LL in the MC groups were significant smaller than in the control group (p<0.05). PI, SS, and PT were significantly correlated with LL with a correlation coefficient of 0.75 PI , 0.71 SS and 0.69 PT (p<0.05). Multivariate logistic regression of the significant variables showed that PI (less than 43.2°) is an independent significant risk factor for MC. ROC analysis showed that moderate diagnostic value was obtained for the significant variable, with an area under the curve (AUC) of 0.80 (p>0.05). Conclusions: We concluded that PI is risk factor for MC, and smaller PI is associated with higher incidence of MC.

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Pelvic Incidence and Lumbar Spine Instability Correlations in Patients with Chronic Low Back Pain

Cited by 9 publications

References 32 publications

Radiographic Incidence of Lumbar Spinal Instability in Patients with Non-spondylolisthetic Low Backache

Radiographic Incidence of Lumbar Spinal Instability in Patients with Non-spondylolisthetic Low Backache

Relationship between the morphology and composition of the lumbar paraspinal and psoas muscles and lumbar intervertebral motion in chronic low‐back pain: An exploratory study

Analysis of the Relationship Between Modic Change and Spinopelvic Parameters in the Sagittal Plane

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