Correlation between Radiographic Parameters and Lordosis in Patients with Chronic Low Back Pain

Area of Science:

• Spinal biomechanics and its relation to chronic pain conditions.
• Radiographic assessment of spinal curvature in adults.

Background:

• Chronic low back pain (CLBP) is a prevalent global health issue with multifactorial causes.
• Clinician beliefs often link changes in lumbar lordosis to LBP, yet normal ranges and measurement practices require re-evaluation.

Purpose of the Study:

• To determine and compare the lumbar lordotic angle (LLA) and lumbosacral angle (LSA) in individuals with and without CLBP.
• To analyze potential correlations between age, gender, body mass index (BMI), and pain severity with LLA and LSA.

Main Methods:

• A prospective case-control study involving 200 adults (100 with CLBP, 100 controls matched for age, gender, BMI).
• Lateral standing radiographs of the lumbar spine were obtained.
• Radiologists blinded to clinical status measured LLA and LSA.

Main Results:

• No significant difference was found in the mean LLA between the CLBP group and the control group (P=0.737).
• A statistically significant difference was observed in the mean LSA between groups (P=0.001), with lower values in the CLBP group.
• Specific subgroups within the CLBP group showed minor variations in LSA (age 31-40, females, overweight) and LLA (males), but neither angle correlated significantly with age, gender, BMI, or pain severity (VAS).

Conclusions:

• Lumbar lordotic angle (LLA) does not appear to significantly differ between individuals with and without nonspecific CLBP.
• Lumbosacral angle (LSA) and LLA show no clear association and only insignificant weak correlations with demographic factors and pain severity.