Analysis of Lumbosacral Lordosis Using Standing Lateral Radiographs Through Curve Reconstruction

Abstract

The consensus of the normal magnitude of lumbosacral curve has not been achieved. The Cobb's angle cannot depict the whole contour of this curve. For practical applications, a clearer image of these curves and their aging changes should be further investigated. This study aimed to provide a more consolidate concept of normal lumbosacral curves for clinician through a computerized reconstruction method. Standing lateral radiographs of lumbosacral spine in 82 normal adults were used for reconstructing the sagittal lumbosacral curves. The geometric characteristics of these curves according to the gender and age groups were studied. Using standing lateral radiographs, reconstruction of the lumbosacral curves was performed through digitization, programming and computation. These curves and related parameters were normalized and averaged for analyzing the differences of gender and age. The most anteriorward and horizontal vertebrae usually occurred on the L4 and L3 in any gender and age groups. The sacral inclination angle did not change obviously with the increasing ages. A tendency of L1 shifting backward was noted in the age groups of 40 to 60 and above 60 years old. The sagittal lumbosacral curves can be easily reconstructed by digitizing lateral radiographs, The aging changes of lumbosacral curves could be qualitatively described as the flattening of lower lumbar curve and the rearward inclination of upper lumbar curve. The changes occurred obviously above 40 years old. Although individual variations existed, the aging changes and the geometric characteristics such as the most anteriorward or horizontal vertebrae could be used as an important guideline during therapy or surgical correction.

Midsagittal Anatomy of Lumbar Lordosis in Adult Egyptians: MRI Study

“…Therefore, there is a need for accurate reconstruction of the lordotic curvature [ 2 ]. However, the current knowledge base for such reconstruction and spinal surgery is insufficient [ 4 ]. The normal range of lumbar lordosis is so wide (30 to 80°) that it becomes difficult to determine its value for an individual [ 2 ].…”