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

Abstract

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.

Scheuermann’s Disease: New Impressions of Clinical and Radiological Evaluation and Treatment Approaches; A Narrative Review

“…Concentrated rehabilitation has shown at least 16% decrease in pain and also delivers mild profits in avoiding advance deformity (28,29). Bracing is the real management for SK, nonetheless, the distress is that its consequences might not be long-lasting deprived of continuing bracing.…”

“…Hyperextension images of above a bolster on the apex of the kyphosis are essential for evaluating the degree of curve flexibility (27,28). Computerized Tomography scan is useful in bony structures diagnosis and measurement of spine angles and pedicle dimensions before surgery (29,30). Some studies showed the severity of thoracic kyphosis is not essentially associated with neurological utility (31).…”

“…Overall, adolescents by Scheuermann's kyphosis must evade actions that include boring, and continuous strain forces on the spine. In unimportant cases, repeated observation might be sufficient (28,29).…”

“…By a mixture of compression on the kyphotic parts and in sequence above multi-segmental Ponte osteotomies, great grades of deformity correction can be attained (28). The Ponte osteotomies permit for kyphosis improvement from only the posterior method (28,29). This type of osteotomy includes subtraction of the spinous process, inferior facets, inferior lamina, and a slice of the superior facets of the lower level.…”

Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

“…The Cobb method is used to measure the magnitude of the coronal deformity [28,29]. CT scan is useful for bony abnormalities and spinal canal and pedicular dimensions especially before surgery [30,31]. MRI needs to be taken to envision any occurrence of canal stenosis, facet hypertrophy, pedicular abnormality, foraminal stenosis, and degenerative disc disease [32][33][34][35].…”