Relationship of sagittal spinal alignment with low back pain and physical performance in the general population

AbstractStudies have suggested a relationship between sagittal spinal malalignment and low back pain (LBP). The current study investigated the relationship of spinal alignment with LBP and physical performance in 1491 individuals who attended the second follow-up visit of the Wakayama Spine Study. The sagittal vertical axis at C7 (C7 SVA) was measured by a spine surgeon. The occurrence of LBP within one month, pain intensity, Oswestry Disability Index (ODI), and physical performance (grip strength, 6-m walking time, chair stand test, one-leg standing test) were also evaluated. LBP in the previous month was determined using ODI, and indicators of physical performance were measured. The mean C7 SVA was 11.0 ± 42.7 mm and was significantly greater in older participants (p < 0.001). LBP was more prevalent in participants with a greater C7 SVA (< 40 mm, 35.7%; 40–95 mm, 47.3%; ≥ 95 mm, 59.4%; p < 0.001) and those with a higher ODI score (10.0%, 17.5%, and 29.4%, respectively; p < 0.001). Physical performance significantly decreased in participants with a greater C7 SVA (p < 0.001). Multiple linear regression analysis revealed that LBP and physical performance were significantly associated with C7 SVA (p < 0.001). Thus, sagittal spinal malalignment may lead to LBP and decreased physical performance.

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Relationship of Sagittal Spinal Alignment With Low Back Pain And Physical Performance In A Population-Based Japanese Cohort: The Wakayama Spine Study

10.21203/rs.3.rs-576310/v1 ◽

2021 ◽

Author(s):

Kazuhiro Hira ◽

Keiji Nagata ◽

Hiroshi Hashizume ◽

Yoshiki Asai ◽

Hiroyuki Oka ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Performance ◽

Linear Regression Analysis ◽

Vertical Axis ◽

Low Back ◽

Spinal Alignment ◽

Sagittal Vertical Axis ◽

Sagittal Spinal Alignment ◽

Sagittal Malalignment

Abstract Studies have suggested a relationship between sagittal malalignment of the spine and low back pain (LBP). The Wakayama Spine Study investigated the relationship between spinal alignment, LBP, and physical performance in 1491 individuals who attended a second follow-up visit as part of the ROAD Study and for whom standing lateral spinal radiographs were available. The sagittal vertical axis at C7 (C7 SVA) was measured by a spinal surgeon. LBP in the previous month was determined by the Oswestry Disability Index (ODI), and indicators of physical performance were measured. The mean C7 SVA was 11.0 ± 42.7 mm and significantly greater in older subjects (p<0.001). Based on their C7 SVA, the subjects were divided into small (<40 mm), intermediate (40≤SVA<95 mm), and large (≥95 mm) groups. LBP was more prevalent in subjects with a larger C7 SVA (small, 35.7%; intermediate, 47.3%; large, 59.4%; p<0.001) and those with a higher ODI score (10.0%, 17.5%, and 29.4%, respectively; p<0.001). Physical performance was significantly decreased in subjects with a larger C7 SVA (p<0.001). Multiple linear regression analysis revealed that LBP and physical performance were significantly associated with C7 SVA (p<0.001). Thus, sagittal malalignment of the spine may lead to LBP and decreased physical performance.

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Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2017.09.008 ◽

2017 ◽

Vol 49 ◽

pp. 128-133 ◽

Cited By ~ 23

Author(s):

Mitsuhiro Masaki ◽

Tomoki Aoyama ◽

Takashi Murakami ◽

Ko Yanase ◽

Xiang Ji ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Mass ◽

Muscle Stiffness ◽

Low Back ◽

Spinal Alignment ◽

Middle Aged ◽

Back Muscles ◽

Sagittal Spinal Alignment

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Sagittal spinal-pelvic alignment in patients with Crowe type IV developmental dysplasia of the hip

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03717-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Peng Ren ◽

Xiangpeng Kong ◽

Wei Chai ◽

Yan Wang

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Vertical Axis ◽

Developmental Dysplasia ◽

Sacral Slope ◽

Low Back ◽

Sagittal Vertical Axis ◽

Type Iv ◽

The Impact ◽

Dysplasia Of The Hip

Abstract Background The impact of high dislocated dysplastic hips on spinal-pelvic alignment has not been well described. This study aims to evaluate compensatory spinal radiographic changes and presence of back pain in patients with Crowe type IV developmental dysplasia of the hip (DDH). Methods An observational study was conducted from July 2016 to December 2017, and 49 consecutive patients with Crowe IV DDH were enrolled. Forty-nine sex- and age-matched asymptomatic healthy adults were recruited as the controls. The sacral slope (SS), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T), and sagittal vertical axis (SVA [C7]) were measured on lateral whole spine radiographs. The presence of low back pain and visual analogue scale (VAS) scores were recorded. Results The patients with Crowe IV DDH showed significantly greater SS (47.5 ± 7.5° vs. 40.4 ± 6.7°, p < 0.05), LL (− 63.7 ± 9.2° vs. − 53.3 ± 11.5°, P < 0.05), SSA (141.8° ± 7.2° vs. 130.6 ± 7.9°, p < 0.05), C7T (93.9 ± 3.6° vs. 91.1 ± 3.7°, P < 0.05), and lower SVA(C7) (− 16 mm[− 95–45] vs. 6.4 mm[− 52–47], p < 0.05) compared to the controls. The patients with bilateral Crowe IV DDH also exhibited larger SS, LL, SSA, and C7T and a smaller SVA (C7) than those with unilateral Crowe IV DDH. Sixty-three percent of the patients with Crowe IV DDH reported low back pain. Conclusion The patients with Crowe IV DDH exhibited abnormal spinal-pelvic alignment characterized by anterior pelvic tilt, lumbar hyperlordosis, and a backward-leaning trunk. Bilateral Crowe IV DDH had a greater impact on spinal-pelvic alignment than unilateral Crowe IV DDH.

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Effects of Physical Therapy on Pain, Functional Status, Sagittal Spinal Alignment, and Spinal Mobility in Chronic Non-specific Low Back Pain

Eurasian Journal of Medicine ◽

10.5152/eurasianjmed.2018.18126 ◽

2019 ◽

Vol 51 (1) ◽

pp. 22-26 ◽

Cited By ~ 3

Author(s):

Meral Bilgilisoy Filiz ◽

◽

Sibel Cubukcu Firat ◽

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Functional Status ◽

Spinal Mobility ◽

Low Back ◽

Spinal Alignment ◽

Sagittal Spinal Alignment

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Knee Spine Syndrome Mechanism in Knee Osteoarthritis: Review Article

Physical Therapy Journal of Indonesia ◽

10.51559/ptji.v1i2.9 ◽

2020 ◽

Vol 1 (2) ◽

pp. 35-37

Author(s):

I Made Buda Kurniantara ◽

Gusti Ayu Alit Triwahyuni

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Knee Osteoarthritis ◽

Lumbar Lordosis ◽

Muscle Activation ◽

Low Back ◽

Spinal Alignment ◽

Sagittal Spinal Alignment ◽

The Future ◽

Knee Contracture

Introduction: Osteoarthritis (OA) is the most common arthritis and one of the main causes of disability. This injury can occur in any joint, but the most common OA occurrence globally, especially in Indonesia, is Knee OA (KOA). Damage caused by KOA's degenerative process affects the knee and affects the surrounding structures, such as the lumbar vertebra, which increases symptoms of low back pain (LBP). The occurrence of symptoms of LBP is thought to be caused by knee spine syndrome, which is a condition reduced lumbar lordosis angle due to the degenerative phase of KOA. the mechanism of this syndrome has not yet been discussed in detail, so further discussion is needed in the future. Methods: We searched articles using a list of keywords, including "knee osteoarthritis and low back pain", "knee osteoarthritis and knee contracture", "knee contracture and muscle weakness", "knee contracture and spinal alignments", "knee osteoarthritis and spinal alignment", "knee osteoarthritis and sagittal spinal alignment", and "muscle activation and spinal imbalance" on the data sources of PubMed, ScienceDirect, and Google Scholar. The argumentative, descriptive analysis was used for the data analysis technique. Results: Based on the literature search, the author found four related articles. This study provides evidence of the effect of KOA on lumbar proprioception. These articles explained that an impact on knee posture could have long-term effects both in the spine and pelvis, such as lumbar lordosis. Conclusion: Knee spine syndrome results from a reduced angle of lumbar lordosis, increasing pressure between discs, which might increase LBP symptoms. In the future, it is hoped that there will be studies that raise the relationship between KOA and symptom of LBP.

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Efficacy of Integrating Cervical Posture Correction With Lumbar Stabilization Exercises for Mechanical Low Back Pain: A Randomized Blinded Clinical Trial

Journal of Applied Biomechanics ◽

10.1123/jab.2020-0005 ◽

2020 ◽

pp. 1-9

Author(s):

Aliaa M. Elabd ◽

Salah-Eldin B. Rasslan ◽

Haytham M Elhafez ◽

Omar M. Elabd ◽

Mohamed A. Behiry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Vertical Axis ◽

Low Back ◽

Sagittal Vertical Axis ◽

Significant Group ◽

Lumbar Stabilization ◽

Group A ◽

Craniovertebral Angle ◽

Cervical Posture

Although current lumbar stabilization exercises are beneficial for chronic mechanical low back pain, further research is recommended focusing on global spinal alignment normalization. This randomized, controlled, blinded trial was conducted to determine the effects of adding cervical posture correction to lumber stabilization on chronic mechanical low back pain. Fifty adult patients (24 males) with chronic mechanical low back pain and forward head posture received 12 weeks treatment of either both programs (group A) or lumbar stabilization (group B). The primary outcome was back pain. The secondary outcomes included the craniovertebral angle, Oswestry Disability Index, C7-S1 sagittal vertical axis, and sagittal intervertebral movements. The multivariate analysis of variance indicated a significant group-by-time interaction (P = .001, partial η2 = .609). Pain, disability, C7-S1 sagittal vertical axis, and l2-l3 intervertebral rotation were reduced in group A more than B (P = .008, .001, .025, and .001). Craniovertebral angle was increased in A when compared to B (P = .001). However, there were no significant group-by-time interactions for other intervertebral movements. Within-group comparisons were significant for all outcomes except for craniovertebral angle within patients in the control group. Adding cervical posture correction with lumber stabilization for management of chronic low back pain seemed to have better effects than the application of a stabilization program only.

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