ANKMJ

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

EndNote Style
Index
Original Article
Is there a relationship between chronic low back pain and spinal sagittal balance? A prospective controlled study
Aims: Evaluation of whether there is a significant relationship between chronic low back pain and spinal sagittal alignment.
Methods: This prospective, controlled study was conducted between April 2023 and September 2023, among patients aged 18–50, who complained of chronic low back pain and a healthy control (HC) group. In addition to the participant's demographic information, sagittal vertical axis (SVA), thoracic kyphosis (TK), and lumbar lordosis (LL) values on the lateral whole-spine radiograph and degenerations on the lumbar vertebra MRI were compared. VAS and ODI scores of the patients were also included in the statistical evaluation.
Results: A total of 64 participants (44 patients, 20 controls) were included in the study. There was no significant difference in age, gender, body mass index (BMI). SVA significantly increased in the patient group (p < 0.001), but not LL and TK. In a linear discriminant analysis (LDA), SVA discriminates 100% of the two groups. No significant correlation was observed between VAS and ODI scores and the patient's age, gender, BMI, and spinal parameters.
Conclusion: SVA is a crucial parameter of spinal balance, and as shown in this study, deviations from normal SVA appear to be a significant contributor to low back pain. We recommend an easy-to-implement and cost-effective method for assessing SVA in evaluating and treating patients with chronic low back pain.


1. Atlas SJ, Deyo RA. Evaluating and managing acute low back painin the primary care setting. J Gener Inter Med. 2001;16(2):120-131.
2. Greenberg MS, Abel N, Agazzi S. Handbook of Neurosurgery. 9thed. Georg Thieme Verlag; 2019: 1497.
3. Hoy D, March L, Brooks P, et al. The global burden of low backpain: estimates from the global burden of disease 2010 study. AnnRheumat Dis. 2014;73(6):968-974.
4. Frymoyer JW. Back Pain and Sciatica. New England J Med.1988;318(5):291-300.
5. Greenberg MS, Abel N, Agazzi S. Handbook of Neurosurgery. 9thed. Georg Thieme Verlag; 2019: 1495.
6. Urits I, Burshtein A, Sharma M, et al. Low back pain, acomprehensive review: pathophysiology, diagnosis, andtreatment. Current Pain Headache Rep. 2019;23(3):1-10.
7. Kim D, Menger RP. Spine Sagittal Balance. StatPearls Publishing;2018.
8. Le Huec JC, Roussouly P. Sagittal spino-pelvic balance is acrucial analysis for normal and degenerative spine. Europ Spine J.2011;20(5):S556-S557.
9. Dubousset J. Three-dimensional analysis of the scolioticdeformity. Pediatr Spine. 1994;479-496.
10. Fairbank JC, Couper J, Davies JB, O&rsquo;Brien JP. The Oswestry lowback pain disability questionnaire. Physiother. 1980;66(8):271-273.
11. Yakut E, D&uuml;ger T, &Ouml;ks&uuml;z &Ccedil;, et al. Validation of the Turkishversion of the oswestry disability index for patients with low backpain. Spine. 2004;29(5):581-585.
12. Greenberg MS, Abel N, Agazzi S. Handbook of Neurosurgery. 9thed. Georg Thieme Verlag; 2019.
13. Pfirrmann CWA, Metzdorf A, Zanetti M, Hodler J, Boos N.Magnetic resonance classification of lumbar intervertebral discdegeneration. Spine. 2001;26(17):1873-1878.
14. Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance ofthe pelvis-spine complex and lumbar degenerative diseases. acomparative study about 85 cases. Europ Spine J. 2007;16(9):1459-1467.
15. Kim YJ, Bridwell KH, Lenke LG, Rhim S, Cheh G. An analysisof sagittal spinal alignment following long adult lumbarinstrumentation and fusion to l5 or S1: can we predict ideallumbar lordosis? Spine. 2006;31(20):2343-2352.
16. Ogon I, Teramoto A, Takashima H, et al. Factors associated withlow back pain in patients with lumbar spinal stenosis: a cross-sectional study. BMC Musculoskelet Disor. 2022;23(1):1-12.
17. Chal&eacute;at-Valayer E, Mac-Thiong JM, Paquet J, Berthonnaud E,Siani F, Roussouly P. Sagittal spino-pelvic alignment in chroniclow back pain. European spine journal : official publication of theEuropean spine society, the European Spinal deformity society,and the European section of the cervical spine research society.2011;20:634-640.
18. Liu H, Li S, Zheng Z, Wang J, Wang H, Li X. Pelvic retroversionis the key protective mechanism of L4-5 degenerativespondylolisthesis. Europ Spine J. 2015;24(6):1204-1211.
19. Abbas J, Hamoud K, May H, et al. Degenerative lumbar spinalstenosis and lumbar spine configuration. Europ Spine J.2010;19(11):1865-1873.
20. Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K. Sagittalspinal alignment in patients with lumbar disc herniation. EuropSpine J. 2010;19(3):435-438.
21. Hira K, Nagata K, Hashizume H, et al. Relationship of sagittalspinal alignment with low back pain and physical performance inthe general population. Scient Rep. 2021;11(1):20604.
22. Stagnara P, De Mauroy JC, Dran G, et al. Reciprocal angulationof vertebral bodies in a sagittal plane: approach to references forthe evaluation of kyphosis and lordosis. Spine. 1982;7(4):335-342.
23. Tatsumi M, Mkoba EM, Suzuki Y, et al. Risk factors of low backpain and the relationship with sagittal vertebral alignment inTanzania. BMC Musculoskelet Dis. 2019;20(1):1-5.
24. Sardar ZM, Cerpa M, Kelly M, et al. Age and gender basedspinopelvic and regional spinal alignment in asymptomatic adultvolunteers: results of the multi-ethnic alignment normative study(MEANS). Spine. 2022;47(19):1382-1390.
25. Miyatani M, Kanehisa H, Azuma K, Kuno S, Fukunaga T. Site-related differences in muscle loss with aging a cross-sectionalsurvey on the muscle thickness in Japanese men aged 20 to 79years. Inter J Sport Health Sci. 2003;1(1):34-40.
Volume 2, Issue 3, 2023
Page : 95-100
_Footer