Research Article
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Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?

Year 2024, Volume: 41 Issue: 1, 108 - 111, 29.03.2024

Kemal Paksoy Ahmet Atilla Abdioğlu

Abstract

The aim of our study is to investigate the effect of acute low back pain on spinopelvic parameters. Pre-pain and post-pain scoliosis radiographs of the patients who applied with the complaint of low back pain of acute onset (less than 12 weeks) were taken. Measurements of the spinopel-vic parameters were performed for each patient, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), and the sagittal vertical axis (SVA). 65 patients were included in the study. In the statistical study in acute low back pain, changes in SVA, PT, LL, and SS were found to be significant (p = 0.014, 0.006, 0.003, 0.003) Lumbar lordosis decreases as a result of pathologies, such as asymmetric disc degeneration and facet joint hypertrophy that occur in a chronic process, and the sagittal imbalance appears as a consequence of all these. After that, the mechanisms utilized to compensate for the resulting sagittal imbalance led to low back pain. However, differently, in the case of acute low back pain, the patient changes the sagittal alignment first, to yield a less painful posture.

Keywords

Acute Back Pain Sagittal Balance Spinopelvic Parameters

References

  • Berthonnaud E, Dimnet J, Roussouly P, Labelle H. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 2005;18(1):40-7
  • During J, Goudfrooij H, Keessen W, Beeker TW, Crowe A. Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions. Spine. 1985;10:83–87. doi: 10.1097/00007632-198501000-00013.
  • Morel E, Ilharreborde B, Lenoir T, Hoffmann E, Vialle R, Rillardon L, et al. Sagittal balance of the spine and degenerative spondylolisthesis [French] Rev Chir Orthop Reparatrice Appar Mot. 2005;91:615–626.
  • Mac-Thiong J-M, Labelle H, Charlebois M, Huot MP, Guise JA. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine. 2003;28:1404–1409.
  • Kim YJ, Bridwell KH, Lenke LG, Rhim SC, Cheh G. An analysis of sagittal spinal align-ment following long adult lumbar instrumentation and fusion to L5 or S1: can we predict ide-al lumbar lordosis ? Spine. 2006;31:2343–2352. doi: 10.1097/01.brs.0000238970.67552.f5.
  • Le Huec JC, Thompson W, Mohsinaly Y, Barrey C, Faundez A. Sagittal balance of the spine. Eur Spine J. 2019 Sep;28(9):1889-1905. doi: 10.1007/s00586-019-06083-1.
  • Ilharreborde B. Sagittal balance and idiopathic scoliosis: does final sagittal alignment influence outcomes, degeneration rate or failure rate? Eur Spine J. 2018 Feb;27(Suppl 1):48-58. doi: 10.1007/s00586-018-5472-9. Epub 2018 Jan 24.
  • Kim D, Davis DD, Menger RP. Spine Sagittal Balance. 2020 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.
  • Agarwal N, Angriman F, Goldschmidt E, Zhou J, Kanter AS, Okonkwo DO, et al. International Spine Study Group. Relationship between body mass index and sagittal vertical axis change as well as health-related quality of life in 564 patients after deformity surgery. J Neurosurg Spine. 2019 Aug 9:1-6.
  • Smith JS, Shaffrey CI, Fu KM, Scheer JK, Bess S, Lafage V, et al. Clinical and radiographic evaluation of the adult spinal deformity patient. Neurosurg Clin N Am 2013;24(2):143–56.
  • Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J. 2011 Sep;20 Suppl 5(Suppl 5):609-18. doi: 10.1007/s00586-011-1928-x. Epub 2011 Aug 2.
  • Radovanovic I , Urquhart JC , Ganapathy V , Siddiqi F , Gurr KR , Bailey SI , et al. Influence of postoperative sagittal balance and spinopelvic parameters on the outcome of patients surgically treated for degenerative lumbar spondylolisthesis. J. Neurosurg. Spine 26 (4) (2017) 448–453.
  • Kim MK , Lee SH, Kim ES, Eoh W, Chung SS, Lee CS. The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a pilot study. BMC Musculoskelet Disord. 2011 Apr 5;12:69.
  • Lazennec JY, Ramaré S, Arafati N, Laudet CG, Gorin M, Roger B, et al. Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J. 2000;9:47–55.
  • Schwab F1, Lafage V, Patel A, Farcy JP. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 2009 Aug 1;34(17):1828-33.
  • Araújo F, Lucas R, Alegrete N, Azevedo A, Barros H. Sagittal standing posture, back pain, and quality of life among adults from the general population: a sex-specific association. Spine (Phila Pa 1976). 2014 Jun 1;39(13):E782-94. doi: 10.1097/BRS.0000000000000347.
  • Ogon I, Takebayashi T, Takashima H, Morita T, Yoshimoto M, Terashima Y, et al. Quantitative Analysis Concerning Atrophy and Fat Infiltration of the Multifidus Muscle with Magnetic Resonance Spectroscopy in Chronic Low Back Pain. Spine Surg Relat Res. 2018 Oct 10;3(2):163-170.
  • Proietti L, Schirò GR, Sessa S, Scaramuzzo L. The impact of sagittal balance on low back pain in patients treated with zygoapophysial facet joint injection. Eur Spine J. 2014 Oct;23 Suppl 6:628-33.
  • Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16:1459–1467.
  • Bourghli A, Aunoble S, Reebye O, Le Huec JC. Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis. Eur Spine J. 2011 Sep;20 Suppl 5:663-8.
  • Labelle H, Roussouly P, Chopin D, Berthonnaud E, Hresko T, O’Brien M. Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J. 2008;17:1170–1176.
  • Barrey C, Roussouly P, Perrin G, Le Huec JC. Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 2011 Sep;20 Suppl 5(Suppl 5):626-33.
  • Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP. Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976). 2009 Aug 1;34(17):E599-606. doi: 10.1097/BRS.0b013e3181aad21

Year 2024, Volume: 41 Issue: 1, 108 - 111, 29.03.2024

Kemal Paksoy Ahmet Atilla Abdioğlu

Abstract

References

  • Berthonnaud E, Dimnet J, Roussouly P, Labelle H. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 2005;18(1):40-7
  • During J, Goudfrooij H, Keessen W, Beeker TW, Crowe A. Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions. Spine. 1985;10:83–87. doi: 10.1097/00007632-198501000-00013.
  • Morel E, Ilharreborde B, Lenoir T, Hoffmann E, Vialle R, Rillardon L, et al. Sagittal balance of the spine and degenerative spondylolisthesis [French] Rev Chir Orthop Reparatrice Appar Mot. 2005;91:615–626.
  • Mac-Thiong J-M, Labelle H, Charlebois M, Huot MP, Guise JA. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine. 2003;28:1404–1409.
  • Kim YJ, Bridwell KH, Lenke LG, Rhim SC, Cheh G. An analysis of sagittal spinal align-ment following long adult lumbar instrumentation and fusion to L5 or S1: can we predict ide-al lumbar lordosis ? Spine. 2006;31:2343–2352. doi: 10.1097/01.brs.0000238970.67552.f5.
  • Le Huec JC, Thompson W, Mohsinaly Y, Barrey C, Faundez A. Sagittal balance of the spine. Eur Spine J. 2019 Sep;28(9):1889-1905. doi: 10.1007/s00586-019-06083-1.
  • Ilharreborde B. Sagittal balance and idiopathic scoliosis: does final sagittal alignment influence outcomes, degeneration rate or failure rate? Eur Spine J. 2018 Feb;27(Suppl 1):48-58. doi: 10.1007/s00586-018-5472-9. Epub 2018 Jan 24.
  • Kim D, Davis DD, Menger RP. Spine Sagittal Balance. 2020 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.
  • Agarwal N, Angriman F, Goldschmidt E, Zhou J, Kanter AS, Okonkwo DO, et al. International Spine Study Group. Relationship between body mass index and sagittal vertical axis change as well as health-related quality of life in 564 patients after deformity surgery. J Neurosurg Spine. 2019 Aug 9:1-6.
  • Smith JS, Shaffrey CI, Fu KM, Scheer JK, Bess S, Lafage V, et al. Clinical and radiographic evaluation of the adult spinal deformity patient. Neurosurg Clin N Am 2013;24(2):143–56.
  • Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J. 2011 Sep;20 Suppl 5(Suppl 5):609-18. doi: 10.1007/s00586-011-1928-x. Epub 2011 Aug 2.
  • Radovanovic I , Urquhart JC , Ganapathy V , Siddiqi F , Gurr KR , Bailey SI , et al. Influence of postoperative sagittal balance and spinopelvic parameters on the outcome of patients surgically treated for degenerative lumbar spondylolisthesis. J. Neurosurg. Spine 26 (4) (2017) 448–453.
  • Kim MK , Lee SH, Kim ES, Eoh W, Chung SS, Lee CS. The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a pilot study. BMC Musculoskelet Disord. 2011 Apr 5;12:69.
  • Lazennec JY, Ramaré S, Arafati N, Laudet CG, Gorin M, Roger B, et al. Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J. 2000;9:47–55.
  • Schwab F1, Lafage V, Patel A, Farcy JP. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 2009 Aug 1;34(17):1828-33.
  • Araújo F, Lucas R, Alegrete N, Azevedo A, Barros H. Sagittal standing posture, back pain, and quality of life among adults from the general population: a sex-specific association. Spine (Phila Pa 1976). 2014 Jun 1;39(13):E782-94. doi: 10.1097/BRS.0000000000000347.
  • Ogon I, Takebayashi T, Takashima H, Morita T, Yoshimoto M, Terashima Y, et al. Quantitative Analysis Concerning Atrophy and Fat Infiltration of the Multifidus Muscle with Magnetic Resonance Spectroscopy in Chronic Low Back Pain. Spine Surg Relat Res. 2018 Oct 10;3(2):163-170.
  • Proietti L, Schirò GR, Sessa S, Scaramuzzo L. The impact of sagittal balance on low back pain in patients treated with zygoapophysial facet joint injection. Eur Spine J. 2014 Oct;23 Suppl 6:628-33.
  • Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16:1459–1467.
  • Bourghli A, Aunoble S, Reebye O, Le Huec JC. Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis. Eur Spine J. 2011 Sep;20 Suppl 5:663-8.
  • Labelle H, Roussouly P, Chopin D, Berthonnaud E, Hresko T, O’Brien M. Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J. 2008;17:1170–1176.
  • Barrey C, Roussouly P, Perrin G, Le Huec JC. Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 2011 Sep;20 Suppl 5(Suppl 5):626-33.
  • Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP. Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976). 2009 Aug 1;34(17):E599-606. doi: 10.1097/BRS.0b013e3181aad21
There are 23 citations in total.

Details

Primary Language English
Subjects Brain and Nerve Surgery (Neurosurgery)
Journal Section Research Article
Authors

Kemal Paksoy 0000-0002-7677-7356

Ahmet Atilla Abdioğlu 0000-0002-0206-8135

Publication Date March 29, 2024
Submission Date September 25, 2023
Acceptance Date February 25, 2024
Published in Issue Year 2024 Volume: 41 Issue: 1

Cite

APA Paksoy, K., & Abdioğlu, A. A. (2024). Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?. Journal of Experimental and Clinical Medicine, 41(1), 108-111.
AMA Paksoy K, Abdioğlu AA. Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?. J. Exp. Clin. Med. March 2024;41(1):108-111.
Chicago Paksoy, Kemal, and Ahmet Atilla Abdioğlu. “Correlation of Acute Back Pain and Sagittal Balance Acute Sagittal Imbalance: A New Term?”. Journal of Experimental and Clinical Medicine 41, no. 1 (March 2024): 108-11.
EndNote Paksoy K, Abdioğlu AA (March 1, 2024) Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?. Journal of Experimental and Clinical Medicine 41 1 108–111.
IEEE K. Paksoy and A. A. Abdioğlu, “Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?”, J. Exp. Clin. Med., vol. 41, no. 1, pp. 108–111, 2024.
ISNAD Paksoy, Kemal - Abdioğlu, Ahmet Atilla. “Correlation of Acute Back Pain and Sagittal Balance Acute Sagittal Imbalance: A New Term?”. Journal of Experimental and Clinical Medicine 41/1 (March 2024), 108-111.
JAMA Paksoy K, Abdioğlu AA. Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?. J. Exp. Clin. Med. 2024;41:108–111.
MLA Paksoy, Kemal and Ahmet Atilla Abdioğlu. “Correlation of Acute Back Pain and Sagittal Balance Acute Sagittal Imbalance: A New Term?”. Journal of Experimental and Clinical Medicine, vol. 41, no. 1, 2024, pp. 108-11.
Vancouver Paksoy K, Abdioğlu AA. Correlation of acute back pain and sagittal balance acute sagittal imbalance: A new term?. J. Exp. Clin. Med. 2024;41(1):108-11.
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