Lumbar spine posture and spinopelvic parameters change in various standing and sitting postures
This study aimed to compare differences in lumbosacral and spinopelvic parameters between pain developers and non-pain developers as well as the effects of various posture changes.
A total of 38 consecutive participants, 20 standing-induced low back pain developers (mean age: 27.7 ± 5.3; mean BMI: 22.64 ± 2.95) and 18 non-pain developers (mean age: 29.0 ± 7.5; mean BMI: 24.2 ± 1.87) (p > 0.05), were prospectively evaluated. Six sagittal plane radiographs were taken. Upright standing posture was used as the reference posture. Lumbar lordosis, lumbosacral lordosis, L1/L2 and L5/S1 intervertebral (IV) joint angles, pelvic incidence, pelvic tilt and sacral slope were measured on each radiograph.
There were no significant differences in terms of age, BMI, SF-36 score, or Oswestry Disability Index scores between pain developer and non-pain developer groups (p > 0.05). Pain developers had significantly larger lumbar lordosis, larger L1/L2 intervertebral angles, larger pelvic incidences and sacral slopes in all postures (p < 0.05). The contribution of L5/S1 intervertebral angle to lumbar flexion was higher than that of the L1/L2 intervertebral angle during stair descent, the sitting and the leaning forward while sitting postures (p < 0.05).
The current study supports the assertion that increased lumbar lordosis is associated with increased pain. Lumbar spine angles change in various postures. The changes were more prominent in pain developers than in non-pain developers. Larger lumbar lordosis due to larger pelvic incidence may be a risk factor for the development of standing-induced low back pain.
KeywordsLow back pain Pain developer Lumbar Posture Spinopelvic Standing-induced
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
- 11.Cohen AL, Gjessing CC, Fine LJ, Bernard BP, McGlothin JD (1997) Elements of ergonomic programs: a primer based on workplace evaluations of musculoskeletal disorders. National Institute of Occupational Health and Safety, CincinnatiGoogle Scholar
- 17.Bontrager KL, Lampignano JP (2014) Bontrager’s handbook of radiographic positioning and techniques, 8th edn. Elsevier Mosby, St. LouisGoogle Scholar
- 19.National Council on Radiation Protection and Measurements (2009) Ionizing radiation, exposure of population in United States. National Council on Radiation Protection and Measurements, BethesdaGoogle Scholar
- 20.U.S. Food and Drug Administration (2009) What are the radiation risks from CT? https://www.fda.gov/RadiationEmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/MedicalX-Rays/ucm115329.htm. Accessed 18 May 2018
- 21.Yochum TR, Rowe LJ (2004) Essentials of skeletal radiology, vol 1, 3rd edn. Lippincott Williams & Wilkins, BaltimoreGoogle Scholar
- 25.Aoki Y, Sugiura S, Nakagawa K, Nakajima A, Takahashi H, Ohtori S, Takahashi K, Nishikawa S (2012) Evaluation of nonspecific low back pain using a new detailed visual analogue scale for patients in motion, standing, and sitting: characterizing nonspecific low back pain in elderly patients. Pain Res Treat 2012:680496. https://doi.org/10.1155/2012/680496 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Astfalck RG, O’Sullivan PB, Straker LM, Smith AJ, Burnett A, Caneiro JP, Dankaerts W (2010) Sitting postures and trunk muscle activity in adolescents with and without nonspecific chronic low back pain: an analysis based on subclassification. Spine (Phila Pa 1976) 35(14):1387–1395. https://doi.org/10.1097/brs.0b013e3181bd3ea6 CrossRefGoogle Scholar
- 31.Duval-Beaupere G, Marty C, Barthel F, Boiseaubert B, Boulay C, Commard MC, Coudert V, Cosson P, Descamps H, Hecquet J, Khoury N, Legaye J, Marpeau M, Montigny JP, Mouilleseaux B, Robin G, Schmitt C, Tardieu C, Tassin JL, Touzeau C (2002) Sagittal profile of the spine prominent part of the pelvis. Stud Health Technol Inform 88:47–64PubMedGoogle Scholar
- 32.De Carvalho DE, Soave D, Ross K, Callaghan JP (2010) Lumbar spine and pelvic posture between standing and sitting: a radiologic investigation including reliability and repeatability of the lumbar lordosis measure. J Manip Physiol Ther 33(1):48–55. https://doi.org/10.1016/j.mpt.2009.11.008 CrossRefGoogle Scholar
- 38.Jentzsch T, Geiger J, Bouaicha S, Slankamenac K, Nguyen-Kim TD, Werner CM (2013) Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine. BMC Med Imaging 13:34. https://doi.org/10.1186/1471-2342-13-34 CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Dankaerts W, O’Sullivan P, Burnett A, Straker L (2006) Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified. Spine (Phila Pa 1976) 31(6):698–704. https://doi.org/10.1097/01.brs.0000202532.76925.d2 CrossRefGoogle Scholar
- 42.Claus AP, Hides JA, Moseley GL, Hodges PW (2018) Different ways to balance the spine in sitting: muscle activity in specific postures differs between individuals with and without a history of back pain in sitting. Clin Biomech 52:25–32. https://doi.org/10.1016/j.clinbiomech.2018.01.003 CrossRefGoogle Scholar
- 44.Obeid I, Boissiere L, Yilgor C, Larrieu D, Pellise F, Alanay A, Acvaroglu E, Perez-Grueso FJ, Kleinstuck F, Vital JM, Bourghli A, European Spine Study Group (2016) Global tilt: a single parameter incorporating spinal and pelvic sagittal parameters and least affected by patient positioning. Eur Spine J 25(11):3644–3649. https://doi.org/10.1007/s00586-016-4649-3 CrossRefPubMedGoogle Scholar