Abstract
Purpose
Despite the high prevalence of low back pain during pregnancy there is still a lack in the understanding of its aetiology. Changes of the spinal posture due to the anatomical changes of the pregnant body seem to be in part responsible for the back pain. In this pilot study we assessed the potential to accurately measure the spinal posture and pelvic position during pregnancy without any harmful radiation using a spine and surface topography system.
Methods
Thirteen pregnant women were examined during the second and third trimester of their pregnancy, and postpartum. Twenty female, non-pregnant volunteers comprised the control group. The spinal posture and pelvic position were measured with a radiation-free spine and surface topography system.
Results
We found a significant increase in thoracic kyphosis during the course of pregnancy, but no increased lumbar lordosis. The lateral deviation of the spine also decreased significantly. However, we did not measure significant changes of the pelvic position during or after pregnancy.
Conclusions
The results of our study show that pregnancy has an effect on the spinal posture, and that spine and surface topography can be used to measure these changes three-dimensionally and without any harmful radiation. In future studies this technique could allow to further evaluate the relationship between posture and low back pain during pregnancy, helping to understand the aetiology of low back pain in pregnancy as well as to identify methods for its prevention and treatment.
Similar content being viewed by others
References
Han IH (2010) Pregnancy and spinal problems. Curr Opin Obstet Gynecol 22(6):477–481. doi:10.1097/GCO.0b013e3283404ea1
Ostgaard HC, Zetherstrom G, Roos-Hansson E (1997) Back pain in relation to pregnancy: a 6-year follow-up. Spine (Phila Pa 1976) 22(24):2945–2950
Okanishi N, Kito N, Akiyama M, Yamamoto M (2012) Spinal curvature and characteristics of postural change in pregnant women. Acta Obstet Gynecol Scand 91(7):856–861. doi:10.1111/j.1600-0412.2012.01400.x
Turner-Smith AR (1988) A television/computer three-dimensional surface shape measurement system. J Biomech 21(6):515–529
Drerup B, Hierholzer E (1987) Movement of the human pelvis and displacement of related anatomical landmarks on the body surface. J Biomech 20(10):971–977
Frerich JM, Hertzler K, Knott P, Mardjetko S (2012) Comparison of radiographic and surface topography measurements in adolescents with idiopathic scoliosis. Open Orthop J 6:261–265. doi:10.2174/1874325001206010261
Guidetti L, Bonavolonta V, Tito A, Reis VM, Gallotta MC, Baldari C (2013) Intra- and interday reliability of spine rasterstereography. Biomed Res Int 2013:745480. doi:10.1155/2013/745480
Mohokum M, Mendoza S, Udo W, Sitter H, Paletta JR, Skwara A (2010) Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length, and trunk inclination: a reliability study. Spine (Phila Pa 1976) 35(14):1353–1358. doi:10.1097/BRS.0b013e3181cbc157
Hackenberg L, Hierholzer E, Liljenqvist U (2002) Accuracy of rasterstereography versus radiography in idiopathic scoliosis after anterior correction and fusion. Stud Health Technol Inform 91:241–245
Goh SPR, Leedman PJ, Singer KP (1999) Rasterstereographic analysis of the thoracic sagittal curvature: a reliability study. J Muscoskel Res 3(2):137–142
Crawford RJ, Price RI, Singer KP (2009) The effect of interspinous implant surgery on back surface shape and radiographic lumbar curvature. Clin Biomech (Bristol, Avon) 24(6):467–472. doi:10.1016/j.clinbiomech.2009.04.003
Kristiansson P, Svardsudd K, von Schoultz B (1996) Serum relaxin, symphyseal pain, and back pain during pregnancy. Am J Obstet Gynecol 175(5):1342–1347
Aldabe D, Ribeiro DC, Milosavljevic S, Dawn Bussey M (2012) Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. Eur Spine J 21(9):1769–1776. doi:10.1007/s00586-012-2162-x
Franklin ME, Conner-Kerr T (1998) An analysis of posture and back pain in the first and third trimesters of pregnancy. J Orthop Sports Phys Ther 28(3):133–138
Borg-Stein J, Dugan SA, Gruber J (2005) Musculoskeletal aspects of pregnancy. Am J Phys Med Rehabil 84(3):180–192
Sipko T, Grygier D, Barczyk K, Eliasz G (2010) The occurrence of strain symptoms in the lumbosacral region and pelvis during pregnancy and after childbirth. J Manipulative Physiol Ther 33(5):370–377. doi:10.1016/j.jmpt.2010.05.006
Whitcome KK, Shapiro LJ, Lieberman DE (2007) Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 450(7172):1075–1078. doi:10.1038/nature06342
Ostgaard HC, Andersson GB, Schultz AB, Miller JA (1993) Influence of some biomechanical factors on low-back pain in pregnancy. Spine (Phila Pa 1976) 18(1):61–65
Moore K, Dumas G, Reid J (1990) Postural changes associated with pregnancy and their relationships with low back pain. Clin Biomech (Bristol, Avon) 5:169–174
Dumas GA, Reid JG, Wolfe LA, Griffin MP, McGrath MJ (1995) Exercise, posture, and back pain during pregnancy. Clin Biomech (Bristol, Avon) 10(2):104–109
Christie HJ, Kumar S, Warren SA (1995) Postural aberrations in low back pain. Arch Phys Med Rehabil 76(3):218–224
Ohlen G, Wredmark T, Spangfort E (1989) Spinal sagittal configuration and mobility related to low-back pain in the female gymnast. Spine (Phila Pa 1976) 14(8):847–850
Salminen JJ, Maki P, Oksanen A, Pentti J (1992) Spinal mobility and trunk muscle strength in 15-year-old schoolchildren with and without low-back pain. Spine (Phila Pa 1976) 17(4):405–411
Keskin EA, Onur O, Keskin HL, Gumus II, Kafali H, Turhan N (2012) Transcutaneous electrical nerve stimulation improves low back pain during pregnancy. Gynecol Obstet Invest 74(1):76–83. doi:10.1159/000337720
Sjodahl J, Gutke A, Oberg B (2013) Predictors for long-term disability in women with persistent postpartum pelvic girdle pain. Eur Spine J. doi:10.1007/s00586-013-2716-6
Acknowledgments
We would like to thank all women for participating in this study. We also thank the team of the Department of Obstetrics and Gynaecology of the University Hospital Duesseldorf for their support. No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Betsch, M., Wehrle, R., Dor, L. et al. Spinal posture and pelvic position during pregnancy: a prospective rasterstereographic pilot study. Eur Spine J 24, 1282–1288 (2015). https://doi.org/10.1007/s00586-014-3521-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-014-3521-6