Spino-pelvic radiological parameters in patients presenting with low back pain in a tertiary care centre in India

Abstract

Objectives: Low back pain is one of the most common and disabling morbidities in the world and its relationship with spino-pelvic parameters is not yet fully understood in the Indian population. Our objective was to study the spino-pelvic parameters in patients who presented to the OPD with low back ache (LBA).Materials and Methods: Cross-sectional study conducted at SGITO, Bangalore between March-August 2018. 90 patients with LBA were asked to take standing lateral radiographs showing the pelvis with both hips and lumbar spine. The lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were calculated; and statistical analysis was done.Results: The mean age of patients was 46 years. The average duration of LBA was 14.5 months. The average PI, SS, PT, and LL among the patients was found to be 52.53 (+/-10.85), 35.08 (+/-9.17), 17.56 (+/-7.72), and 49 (+/-3) respectively.PI had statistically significant association with PT and SS but not with LL among both men and women in all age groups. Mean PI and PT was found to be higher in women (53.82+/- 11.85) (18.35 +/- 8.45) and in above 50 years age group (54.58 +/-11.41). Similarly, the mean PT was higher in among women (18.35 +/- 8.45) and in the above 50 years age group (18.93 +/- 8.02). The duration of lower back pain was found to be positively associated with PI, SS, PT, and LL but didn’t reach statistical significance.Conclusion: Spino-pelvic alignment is maintained in patients with low back pain and differences in sagittal alignment in patients with low back ache are minor and clinically, multiple factors contribute to LBA. However, further studies need to be conducted to corroborate these findings in the Indian population which may help in early detection and management of patients prone to develop lumbar disc degeneration and low back ache.