Affiliation:
1. Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil
2. Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil; Santa Casa de São Paulo, Brazil
Abstract
ABSTRACT Objective: To evaluateboth the correlation between lumbar accommodation and pelvic parametersin different types of lordosis and the participation of different lumbar segments in the accommodation of lordosis in the standing and sitting positions. Methods: A retrospective study analyzingpatient images in standing and sitting positions. Correlations were conducted among the measured data: Cobb angle of the lumbar lordosis (LL,type of lordosis, pelvic incidence (PI),sacral slope (SS),pelvic tilt (PT), and the angulation of the L1-L2/L2-L3/L3-L4/L4-L5/L5-S1 segments. Results: Fortypatients were included, 20 men and 20 women. The mean age was 60.8 (±11.5). Of these patients, 10.3% were classified as Roussouly type 2, 35.9% as type 3, 25.6% as type 3A, and 28.2%as type 4.There was a weakcorrelation between LL and PT, however, an inverse correlation between the two (r=-0.183 and p=0.264) was observed. SS hadthe strongest correlation with LL (r> 0.75). Only the correlation between LL and PI was stronger when sitting than standing (p=0.014). The pelvic parameters and angulations of the segments and lumbar discs when standing and sitting were different (p<0.05). In both positions, there was a difference in the contribution of the segments to the LL (p<0.001). On average, the differences in LL between standing and sitting wereequal among theRoussouly classifications (p=0.332). Conclusions: There was a correlation between the LL and the pelvic parameters, being more evident with the SS than with the other parameters. There was no difference in the accommodation of the LL in the different Roussouly types either standing or sitting. Regardless of the position,the L4-S1 segments were predominant in the composition of LL. Level of evidence IV; Retrospective.
Subject
Neurology (clinical),Orthopedics and Sports Medicine,Surgery
Reference42 articles.
1. The Edwin Smith surgical papyrus, published in facsimile and hieroglyphic transliteration with translation and commentary in two volumes;Breasted JH,1930
2. Galen on the affected parts. Translation from the Greek text with explanatory notes [Internet];Galen Siegel RE,1976
3. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparativestudyabout 85 cases;Barrey C;EurSpine J,2007
4. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age5 sex, and size:A prospective controlled clinical study;Jackson RP;Spine,1994
5. Sagital balance of the spine;Roussouly P,2019