Ushnish Mukherjee1, Sourav Kundu2, Rachit Gulati3, Prabir Mandal4
BACKGROUND
Chronic low back pain (CLBP) is one of the common debilitating condition in
middle-age population. Often the pain is "non-specific" or related to mechanical
origin; so, often it is termed as chronic mechanical low back pain. Among the
various predisposing factors, abnormal lumber lordosis is more often seen.
Radiographic assessment of lumbar lordosis can be done by measuring
lumbosacral angle (LSA). Therefore, study of variations in LSA among these
patients can give important clues in both pathogenesis and management. The aim
of the study is to determine different factors leading to the variations of
lumbosacral angle amongst the middle-aged patients presenting with chronic
mechanical low back pain.
METHODS
This retrospective study was conducted by analysing records of 105 CLBP patients
of both sex (male = 32, female = 73) in the age group of 45 - 65 years. LSA was
directly measured digitally by Ferguson technique from the selected patients’
lateral lumbosacral radiographs. Data was collected in Microsoft Excel 2016 and
analysis was done with International Business Machines Statistical Package for the
Social Sciences (IBM SPSS) Statistics version 23.
RESULTS
The difference in median of LSA of male [Median (IQR) = 37.00 (10.00)] and
female [Median (IQR) = 45.00 (8.50)] patients was statistically significant (p-value
0.000). Significant positive correlation was also found between LSA and BMI for
both sexes, but more in case of female (Spearman’s rho 0.806 p = 0.000) than
male (Spearman’s rho 0.680 p-value 0.000).
CONCLUSIONS
Variation of LSA was found to have significant relations with sex and body mass
index (BMI), but not with the age. Statistically significant positive correlation
between LSA and BMI alongside higher BMI of the females in the study group
suggested that they are more prone to develop CLBP. To formulate proper
rehabilitation protocol for middle aged CLBP patients, LSA variations and related
factors can be kept in mind.
