SIB# 391-Low Back Pain and Sagittal Spinal Alignment

The Study: Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania

The Facts:

a. The study was conducted in Tanzania.

b.  The authors state, “Studies report that LBP and pelvic angle are interrelated, and African residents have a high pelvic tilt.”

c. The authors, with the exception of Egfrid Michael Mkoba, are all from the “Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University” in Japan.

d. The study was conducted at the, “Kilimanjaro Christian Medical Centre”.

e. The study included 68 subjects, 16 of which had LBP symptoms.

f. A number of measurements were taken on the subjects, but no radiographs were taken in this study.

f. A PALM palpation meter was used to measure Pelvic angle.

g. The authors found no significant difference in the lumbar lordosis and the abdominal muscular strength between those who had LBP and those who did not. However, they did note that their method of measurement could not accurately measure the lumbar curves in the more obese subjects.

h.  The study found that subjects with low back pain had “a large anteversion of the pelvic angle and a posture of thoracic kyphosis and demonstrate that evaluation should not only focus on hyperlordosis of the lumbar spine but also, and perhaps more importantly, on the anterior tilt of the pelvis and the mobility of the thoracic vertebrae with a large kyphosis.”

i. The authors noted sagittal vertebral alignment was critically important that for those dealing with the care for spinal problems.

Take Home: Structural problems of the spine can cause symptoms. Pelvic tilt appears to be associated with LBP in this study.

Reviewer's Comments:

I am always concerned about the accuracy of spinal structural measurements that do not use some form of imaging to make the measurements. But I like that idea that another group of researchers is looking at another group of subjects and finding that structure is important in humans just as it is in the rest of the universe.

Reviewer:  Roger Coleman DC

Editor: Mark R. Payne DC

Reference: Masataka Tatsumi, Egfrid Michael Mkoba, Yusuke Suzuki, Yuu Kajiwara, Hala Zeidan, Keiko Harada, Tsubasa Bitoh, Yuichi Nishida, Kengo Nakai, Kanako Shimoura and Tomoki Aoyamal. Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania. BMC Musculoskeletal Disorders (2019) 20:584

Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/31801500

Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894267/