The importance of spinopelvic parameters in patients with lumbar disc lesions

Rajnics, Péter; Templier, Alexandre; Skalli, Wafa; Lavaste, F.; Illés, Tamás

doi:10.1007/s00264-001-0317-1

Cited by 104 publications

(28 citation statements)

References 6 publications

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“…Summating both sacral sharpness and lumbar lordosis as global lumbosacral angle, a statistically significant association to lumbar degenerative disc pathologies was found in our series. Furthermore, in subject group the body of S1 exhibited less funneling in shape, which is comparable with other investigations focusing on more vertical sacrum in patients with lumbosacral discopathy [ 7 , 10 ]. Nevertheless, S1 angle was not significantly different between the subjects and the controls; besides, the difference of lumbar lordosis between the two groups was not significant in our study.…”

Section: Discussionsupporting

confidence: 88%

“…In contrast to numerous discussions regarding the relationship between lordosis and LBP, only a few controlled studies have assessed the correlation of lumbar sagittal alignment to degenerative disc disease (DDD) or disc herniation (DH) [ 7 ]. Spino-pelvic morphology and sacral alignment received even less attention in this regard [ 4 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

et al. 2014

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Study DesignA cross-sectional case-control study was designed to compare the sagittal alignment of lumbosacral regions in two groups of patients suffering from low back pain, one with intervertebral disc pathologies and one without.PurposeTo evaluate the correlation between lumbosacral sagittal alignment and disc degeneration.Overview of LiteratureChanges in lumbar lordosis and pelvic parameters in degenerative disc lesions have been assessed in few studies. Overall, patients with discopathy were shown to have lower lumbar lordosis and more vertical sacral profiles.MethodsFrom patients with intractable low back pain undergoing lumbosacral magnetic resonance imaging, 50 subjects with disc degeneration and 50 controls with normal scans were consecutively enrolled. A method was defined with anterior tangent-lines going through anterior bodies of L1 and S1 to measure global lumbosacral angle, incorporating both lumbar lordosis and sacral slope. Global lumbosacral angle using the proposed method and lumbar lordosis using Cobb's method were measured in both groups.ResultsLumbar lordosis based on Cobb's method was lower in group with discopathy (20°-67°; mean, 40.48°±9.89°) than control group (30°-62°; mean, 44.96°±7.68°), although it was not statistically significant. The proposed global lumbosacral angle in subject group (53°-103°; mean, 76.5°±11.018°) was less than control group (52°-101°; mean, 80.18°±9.95°), with the difference being statistically significant (p=0.002).ConclusionsPatients with intervertebral disc lesions seem to have more straightened lumbosacral profiles, but it has not been proven which comes first: disc degeneration or changes in sagittal alignment. Finding an answer to this dilemma demands more comprehensive long-term prospective studies.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

et al. 2014

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“…On the other hand, high levels of LL and SA, especially via passive means, may contribute to tissue strain and injury (Hamill et al, 1995). Clinical evidence suggests a link between LL and spinal pathology (Berlemann et al, 1999;Umehara et al, 2000;Kumar et al, 2001;Rajnics et al, 2002;Labelle et al, 2005;Barrey et al, 2007;Chen and Wei, 2009). Furthermore, the results of this study show that increased SA is associated with increased dynamic lumbar compliance, possibly suggesting higher amounts of strain in back tissues.…”

Section: Discussionmentioning

confidence: 56%

Shock attenuation in the human lumbar spine during walking and running

Castillo

Lieberman

2018

Journal of Experimental Biology

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During locomotion, each step generates a shock wave that travels through the body toward the head. Without mechanisms for attenuation, repeated shocks can lead to pathology. Shock attenuation (SA) in the lower limb has been well studied, but little is known about how posture affects SA in the spine. To test the hypothesis that lumbar lordosis (LL) contributes to SA, 27 adults (14 male, 13 female) walked and ran on a treadmill. Two lightweight, tri-axial accelerometers were affixed to the skin overlying T12/L1 and L5/S1. Sagittal plane accelerations were analyzed using power spectral density analysis, and lumbar SA was assessed within the impact-related frequency range. 3D kinematics quantified dynamic and resting LL. To examine the effects of intervertebral discs on spinal SA, supine MRI scans were used to measure disc morphology. The results showed no association between LL and SA during walking, but LL correlated with SA during running (<0.01, =0.30), resulting in as much as 64% reduction in shock signal power among individuals with the highest LL. Patterns of lumbar spinal motion partially explain differences in SA: larger amplitudes of LL angular displacement and slower angular displacement velocity during running were associated with greater lumbar SA (=0.008, =0.41). Intervertebral discs were associated with greater SA during running (=0.02, =0.22) but, after controlling for disc thickness, LL remained strongly associated with SA (=0.001, =0.44). These findings support the hypothesis that LL plays an important role in attenuating impact shocks transmitted through the human spine during high-impact, dynamic activities such as running.

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“…Many studies have reported spinopelvic parameters in normal and low back pain populations5,7,9,16,17,19). PI is an important anatomic parameter that describes the anatomic configuration of the pelvis and greatly influences the sagittal configuration of the spine4,10,11).…”

Section: Discussionmentioning

confidence: 99%

Difference of Sagittal Spinopelvic Alignments between Degenerative Spondylolisthesis and Isthmic Spondylolisthesis

Lim

Kim

2013

J Korean Neurosurg Soc

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ObjectiveThe purpose of this study was to analyze the differences of spinopelvic parameters between degenerative spondylolisthesis (DSPL) and isthmic spondylolisthesis (ISPL) patients.MethodsThirty-four patients with DSPL and 19 patients with ISPL were included in this study. Spinopelvic parameters were evaluated on whole spine X-rays in a standing position. The following spinopelvic parameters were measured : pelvic incidence (PI), sacral slope, pelvic tilt (PT), lumbar lordosis (LL), and sagittal vertical axis from C7 plumb line (SVA). The population of patients was compared with a control population of 30 normal and asymptomatic adults.ResultsThere were statistically significant differences in LL (p=0.004) and SVA (p=0.005) between the DSPL and ISPL group. The LL of DSPL (42±13°) was significantly lower than that of the control group (48±11°; p=0.029), but that of ISPL (55±6°) was significantly greater than a control group (p=0.004). The SVA of DSPL (55±49 mm) was greater than that of a control group (<40 mm), but that of ISPL (21±22 mm) was within 40 mm as that of a control group. The PT of DSPL (24±7°) and ISPL (21±7°) was significantly greater than that of a control group (11±6°; p=0.000).ConclusionBoth symptomatic DSPL and ISPL patients had a greater PI than that of the asymptomatic control group. In conclusion, DSPL populations are likely to have global sagittal imbalance (high SVA) compared with ISPL populations because of the difference of lumbar lordosis between two groups.

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The importance of spinopelvic parameters in patients with lumbar disc lesions

Cited by 104 publications

References 6 publications

Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

Shock attenuation in the human lumbar spine during walking and running

Difference of Sagittal Spinopelvic Alignments between Degenerative Spondylolisthesis and Isthmic Spondylolisthesis

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