Do spino-pelvic parameters play a role in development of chronic low backache: A prospective analysis

• Main Authors: Roop Singh, Sushil K Yadav, Rohtas K Yadav, Jitendra Wadhwani, Rajesh K Rohilla, Ravi Rohilla
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Indian Spine Journal
• Subjects: low back pain; lumbar lordosis angle; pelvic incidence; spino-pelvic alignment
• Online Access: http://www.isjonline.com/article.asp?issn=2589-5079;year=2021;volume=4;issue=1;spage=105;epage=112;aulast=Singh
• ISSN: 2589-5079; 2589-5087

Introduction: The sagittal spino-pelvic alignment patterns are still poorly understood in patients with chronic low back pain (LBP). Clinical observations suggest that aberrations of posture may play a role in the development of LBP. This study was undertaken with the aim to evaluate spino-pelvic parameters in patients with LBP and with a hypothesis that variation in these may predispose to LBP. Materials and Methods: Fifty patients (26 men and 24 women) with mean age 33.54 ± 8.33 years with a history of LBP of minimum 3 consecutive months constituted the study group and were subjected to standing sagittal spino-pelvic radiographs. Data were analyzed and compared with normative data. Results: The mean values of pelvic incidence (PI) and lumbar lordosis angle (LLA) were 48.52 ± 8.99 and 58.78 ± 9.51, respectively. The correlation of PI with lumbosacral angle (LSA), age, body mass index (BMI), and gender was not significant, but a significant correlation was observed with LLA, pelvic angle (PA), pelvic overhang (PO), pelvic tilt (PT), sacrofemoral distance (SFD), sacral horizontal angle (SHA), and sacropelvic translation (SPT). Sacral inclination angle (SIA), SHA, and PI were found to be significantly positively correlated with LLA, whereas pelvisacral angle (PSA), sacropelvic angle (PRS1), and SPT were found to be significantly negatively correlated. Statistically significant difference was observed only regarding pelvic thickness (PTH) and pelvic radius (PR) between patients with chronic LBP and healthy population. Conclusion: Most significant parameters (PI and LLA) used in spino-pelvic balance assessment have a positive significant correlation with majority of the other parameters and the harmony between them help in maintaining normal spinal column stability and alignment. Variation in some of the spino-pelvic parameters (PTH and PR) may predispose to LBP by putting stresses on the spinal column components and stabilizers.