Lumbosacral Angle Variations in Middle Aged Patients with Chronic Low Back Pain - A Retrospective Study

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. KEYWORDS Chronic Low Back Pain (CLBP), Lumbosacral Angle (LSA), Lordosis, Rehabilitation, Body Mass Index, Lordosis, Spine, Radiography, Rehabilitation