Radiographic lumbosacral angle has a low yield for diagnosing low back pain in workers 20-70 years of age
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Abstract
BACKGROUND
The increasing trend of working from home (WFH) among workers may lead to prolonged sitting time, which is associated with increased complaints of low back pain (LBP). The lumbosacral angle (LSA) is one of the clinically important radiographic angles related to the curves commonly measured to evaluate the biomechanical factors linked with LBP. The purpose of this study was to determine the yield of radiographic LSA for diagnosing LBP among workers aged 20-70 years.
METHODS
An analytic cross-sectional study involving 119 participants was carried out in Trisakti University. Lumbosacral angle was measured using Ferguson’s method. Data regarding LBP symptoms, sitting duration, and sitting position were collected using a questionnaire. Sensitivity and specificity was used to describe the characteristics of LSA as a screening test of LBP.
RESULTS
The subjects consisted of 66 women (55.5%) and 53 men (44.5 %). Their ages ranged from 20 to 64 years with a median age of 40.0 years. Mean LSA was 37.4 ± 7.3º, while the prevalence of LBP was 75 (63.0%). The optimal cut-off value of LSA for the prediction of LBP was 49.5% (95% CI: 0.385-0.606). The sensitivity, specificity, positive predictive value and negative predictive value of LSA in detecting LBP were 58.7%, 45.5%, 68.8%, and 43.6%.
CONCLUSIONS
The radiographic lumbosacral angle has a low yield for the diagnosis of LBP among workers aged 20-70 years. Further studies are needed to confirm our results and to test the application of this measurement.
Article Details
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References
Galanti T, Guidetti G, Mazzei E, Zappalà S, Toscano F. Work from home during the COVID-19 outbreak: the impact on employees’ remote work productivity, engagement, and stress. J Occup Environ Med 2021;63:E426-E2. doi:10.1097/JOM.0000000000002236.
Bailly F, Genevay S, Foltz V, et al. Effects of COVID-19 lockdown on low back pain intensity in chronic low back pain patients: results of the multicenter CONFI-LOMB study. Eur Spine J 2022;31:159-66. doi: 10.1007/s00586-021-07007-8.
Jha AK, Ravi C. A study of normal variation in lumbosacral angle in asymptomatic patients attending orthopaedic out-patient department of a medical college hospital, Telangana. Indian J Orthop Surg 2020;4:16–20. https://doi.org/10.18231/2395-1362.2018.0005.
Cho IY, Park SY, Park JH, Kim TK, Jung TW, Lee HM. The effect of standing and different sitting positions on lumbar lordosis: radiographic study of 30 healthy volunteers. Asian Spine J 2015;9: 762–9. doi: 10.4184/asj.2015.9.5.762.
Aminoff MJ, Boller F, Swaab DF, Barnes MP, Good DC. Handbook of clinical neurology. Vol. 110. Oxford: Elsevier;2013.
Kocyigit BF, Berk E. Comparison of lumbosacral alignment in geriatric and non-geriatric patients suffering low back pain. Pakistan J Med Sci 2018; 34:282–7. doi: 10.12669/pjms.342.13969.
Shortz SK, Haas M. Relationship between radiographic lumbosacral spine mensuration and chronic low back pain intensity: a cross-sectional study. J Chiropr Med 2018;17:1–6. doi: 10.1016/j.jcm.2017.10.005.
Mukherjee U, Kundu S, Gulati R, Mandal P. Lumbosacral angle variations in middle aged patients with chronic low back pain - a retrospective study. J Evid Based Med Healthc 2021;8:208–12. DOI: 10.18410/jebmh/2021/40.
Caglayan M, Tacar O, Demirant A, Oktayoglu P, Karakoc M, Cetin A. Effects of lumbosacral angles on development of low back pain. J Musculoskelet Pain 2014;22:251–5. https://doi.org/10.3109/10582452.2014.907855.
Keskin Y, Ürkmez B, Öztürk F, Kepekçi M, Aydýn T. Correlation between sitting duration and position and lumbar pain among office workers. Haydarpasa Numune Med J 2021;61:1–6. doi: 10.14744/hnhj.2019.04909.
Wong AYL, Chan TPM, Chau AWM, et al. Do different sitting postures affect spinal biomechanics of asymptomatic individuals? Gait Posture 2019;67:230–5. doi: 10.1016/j.gaitpost.2018.10.028
Bontrup C, Taylor WR, Fliesser M, et al. Low back pain and its relationship with sitting behaviour among sedentary office workers. Appl Ergon 2019;81:102894. doi: 10.1016/j.apergo.2019.102894.
Jung KS, Jung JH, In TS, Cho HY. Effects of prolonged sitting with slumped posture on trunk muscular fatigue in adolescents with and without chronic lower back pain. Med 2021;57:1-8. doi: 10.3390/medicina57010003.
Cheung KM. The relationship between disc degeneration, low back pain, and human pain genetics. Spine J 2010;10:958-60. doi: 10.1016/j.spinee.2010.09.011.
Maatta JH, Wadge S, MacGregor A, Karppinen J, Williams FM. ISSLS prize winner: vertebral endplate (Modic) change is an independent risk factor for episodes of severe and disabling low back pain. Spine (Phila Pa 1976) 2015;40:1187-93. doi: 10.1097/BRS.0000000000000937.
Patrianingrum M, Oktaliansah E, Surahman E. Prevalence and risk factors of lower back pain in the anesthesiology workplace in Dr. Hasan Sadikin General Hospital Bandung. J Anestesi Perioper 2015;3:47–56. doi: 10.15851/jap.v3n1.379.
Ferguson AB. Roentgen diagnosis of the extremities and spine. 2nd ed. New York: Paul B. Hoeber, Inc.;1949.
De Baranda PS, Cejudo A, Martínez-Romero MT, et al. Sitting posture, sagittal spinal curvatures and back pain in 8 to 12-year-old children from the region of Murcia (Spain): ISQUIOS programme. Int J Environ Res Public Health 2020;17:1–18. doi: 10.3390/ijerph17072578.
Melani I, Saraswati PAS, WahyuniN. Hubungan posisi duduk dengan nyeri punggung bawah non spesifik pada bagian adminitrasi dan pelayanan di Polda Bali. Maj Ilm Fisioter Indones 2019;7:12–5. DOI: https://doi.org/10.24843/MIFI.2019.v07.i01.p08.
Maduforo C, West O, Nwankwo N, Onwuchekwa R, Etawo US, Ogbulu D. Study of the lumbosacral angles of males in Port Harcourt, South South, Nigeria. Niger Health J 2012;12:22 4.
Okpala FO. Measurement of lumbosacral angle in normal radiographs: a retrospective study in Southeast Nigeria. Ann Med Health Sci Res 2014; 4:757-62.
Hey HWD, Wong CG, Lau ETC, et al. Differences in erect sitting and natural sitting spinal alignment—insights into a new paradigm and implications in deformity correction. Spine J 2017;17:183-9. doi: 10.1016/j.spinee.2016.08.026.
Naqvi SZG, Ali A, Siddiqui A, Ali SD, Qureshi M, Aliuddin IM. Measurement of lumbosacral angle in normal radiographs: a cross-sectional study. J Liaquat Univ Med Heal Sci 2020;19:238–41. doi: 10.22442/jumhs.201940697.
Thakur B, Prashar R, Bhoil R, Rana S, Gupta U. Evaluation of geometrical angles in lumbo-sacral spine on digital radiographs in North Indian population. Int J Health Clin Res 2021;4:132–5.
Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev 2021;9: CD009790. doi: 10.1002/14651858.CD009790.pub2.