The biomechanics of the lumbosacral region in acute and chronic low back pain patients.

BACKGROUND A previous study examined the relationship between the sacral inclination angle (SIA), lumbosacral angle (LSA) and sacral horizontal angle (SHA) and spinal mobility in acute low back pain and chronic low back pain patients. We chose to investigate the lumbar lordosis angle, segmental lumbar lordosis angle, SIA, LSA and SHA in acute and chronic low back pain (LBP) patients as well as the correlation between spinal stability and these angles. OBJECTIVES To investigate the biomechanics of the lumbosacral spine region in acute and chronic LBP patients, as well as to examine the correlation between spinal stability and lumbosacral angles. STUDY DESIGN Randomized controlled evaluation SETTING Physical Medicine and Rehabilitation outpatient clinic METHODS Sixty participants with LBP were recruited and categorized as either acute LBP (pain < 3 months) or chronic LBP (pain > 6 months), with 30 subjects in each group. All subjects underwent standing, lateral lumbosacral x-rays, which were analyzed for lumbar stability, SIA, LSA, SHA, lumbar lordosis angle and segmental lumbar lordosis angles. RESULTS The mean age of the ALBP subjects was 41.00 +/- 11.63 (18 - 66) and that of the chronic LBP subjects 49.26 +/- 15.6 (22-74), with females comprising 50% of the acute LBP group and 73.3% of the chronic LBP group. Lumbar stability was observed in 62.1% of acute LBP patients and 36.8% of chronic LBP patients. A statistically significant difference was found between the 2 groups in terms of age, gender, and lumbar stability. There was no statistical difference regarding SIA, LSA, SHA, total and segmental lordosis angles between acute and chronic LBP patients (p>0.05). CONCLUSION We were unable to find a difference between the radiological values for the shape of the SIA, LSA, SHA, and total and segmental lordosis as noted on screening x-ray techniques regarding the occurrence of acute or chronic LBP, but a statistically significant difference was found for lumbar stability. Further extensive studies are needed to examine lumbar stability and its relationship between angles of lumbosacral region.