A Study of normal variation in lumbosacral angle in asymptomatic patients attending orthopaedic out-patient department of a medical college hospital, Telangana

Abstract

Introduction: The Lumbosacral angle (LSA), is the angle formed between a line across the plane of the superior margin of the sacrum and a horizontal line. Various literature and studies around the world shows wide normal variation in LS angle, ranging from 32 0 to 44 0. Abnormal variation in LS angle is commonly associated with low back pain. Hence research involving study of normal variation of LSA in different ethnic population plays a significant role. In Indian scenario very few studies are available, especially from rural population, to know up to what extent, variation in LS angle is normal. Hence, the present study attempts to study the normal variation in LSA in rural population of Telangana. Materials and Methods: A descriptive study of normal LSA variability, involving 100 asymptomatic subjects between the age group of 20-60 years was carried out in orthopedic department of Medical College hospital, Telangana. Ferguson's technique was employed for calculation of LSA. Results: In this study variation of LSA ranges from 28 0 to 60 0. Overall average LSA was 34 0 .Females have greater average LSA as compared to males. Conclusion: Results of the present study show variability when compared to other similar studies, which further strengthen the fact that normal variation in LSA differs among different region and races; hence results of the present study will be a useful tool to health care providers for treating different spinal disorders of rural Telangana population.

Radiographic lumbosacral angle has a low yield for diagnosing low back pain in workers 20-70 years of age

“…The discrepancy in the findings of these studies and the non-significant correlation between LSA and sitting position may be caused by many factors, including variation in sample size, variation in normal LSA cut-off values, and lack of proper education for the participants with regard to their detailed sitting position in filling out the questionnaire in the present study may contribute to variations in our results. In regard to optimal LSA cut-off value for detecting LBP (37.21º), our study is in line with the study of Jha and Ravi (3) which noted an optimal cut-off value of 32.42º for detecting LBP. The normal LSA cut-off values in the studies of Maduforo et al (20) and Okpala (21) are 36º and 44.5º, respectively.…”

“…(17) The latter method is to first draw the AB line (a line parallel to the superior border of the sacrum), then draw the AC line (horizontal line to the sacrum). (3,8,9) The lumbosacral angle of each subject was measured by experienced radiologists using computerized methods and recorded on a research sheet; then, the editing and coding process was carried out on a computer hard disk and the data cleansed electronically. After having the lumbosacral radiograph taken, each of the subjects was asked to fill the questionnaire.…”

“…(2,7) The risk of LBP was reported to increase in LSA of more than 42 degrees. (3,7) Its value is also related to gender, where the LSA value in women is found to be greater than that of men. (8) A previous study reported that changes in LSA may cause LBP, which may guide healthcare providers to include physicians to make decisions clinically, when examining patients with LBP.…”

“…Low back pain is a pain syndrome that occurs in the lower back region. (3) Although the cause in 80-90% of cases of LBP is unknown or nonspecific, it has been reported that workers tend to spend a lot of time working in front of a computer or laptop for hours in a sitting position without the sitting being interspersed with other physical activities, which can trigger LBP that commonly occurs in the lumbosacral region. (4,5) To withstand heavy loads throughout the day, a good lumbosacral curvature is needed so that it can function in supporting the load.…”

“…Many methods are used to measure this curvature, one that has become the gold standard is the measurement of the lumbosacral angle (LSA) on lateral projection lumbar radiographs. (3) The lumbosacral angle is formed by the intersection of two lines, namely a line drawn across the superior endplate of the S1 vertebra and a horizontal line. (6) Aside from other lateral lumbosacral spine mensuration such as lumbar lordosis (LL), lumbosacral disc angle (LSDA) and sacral inclination (SI), the LSA has been associated with some degree of instability and LBP, therefore knowledge of the LSA range is critical in the management of LBP.…”