![]() ![]() VP vertebra prominens, DM midpoint between dimples, ICT inflectional point of the curvature from cervical to thoracic spine, ITL inflectional point of the curvature from thoracic to lumbar spine, ILS inflectional point of the curvature from lumbar to sacral spine While there were no significant differences between younger male controls and patients in age or anthropometric data, we found significant differences between younger female controls and younger female patients: the controls were about 4.5 years younger ( P = 0.005), their weight was about 5 kg less ( P = 0.001), and their body mass index was about 1 kg/m 2 less ( P = 0.000), too (Table 1). According to the purpose of this study, LBP patients were divided into a sample of under-40-year olds, ranging from 19 to 40 years (LBP under 40, n = 58) and a sample of patients older than 40 years (LBP over 40, n = 155), ranging from 41 to 79 years. ![]() In fact, age was ranging between 18 and 39 years within the controls. Prior to the beginning of data acquisition in the year 2006, a cut-off was fixed for a reference sample of controls for an age interval, where the influence of growth (minimum 18 years of age) or degeneration (maximum 40 years of age) was supposed to be minimized. The controls were included if there was no diagnosis dealing with back pain complaints, no serious back pain history for 2 years, and no back pain at all in the last 6 months. Specific signs, such as vertebral fractures, spinal surgery, or acute sciatic symptoms and especially spinal disorders affecting the spinal alignment, e.g., Morbus Bechterev, Morbus Scheuermann or severe scoliosis, were exclusion criteria. In fact, back pain history varied from 6 months to more than 9 years (average 8 months) and most of the patients had gone through several clinical treatment trials before. Patients came from outpatient rehabilitation and could be included after clinical and radiographic examinations by an orthopedic physician, who qualified the complaints as chronic unspecific back pain (LBP) whenever no correlation with structural or organic signs could be established and when patients had suffered from low back pain for a time period of 6 months minimum. The present investigation was aiming at separating age influences from low back pain-related spinal alignment deviations.īMI body mass index, SD standard deviation, n sample size In view of the corresponding literature, especially the sagittal plane parameters could have been affected by interfering influences of age. ![]() Using video rasterstereography and multivariate analysis procedures, frontal plane (e.g., trunk imbalance and pelvis torsion) and sagittal plane (e.g., trunk inclination, lordosis angle) spine shape parameters could be identified to be associated with chronic low back pain in an adult population, ranging in age from 19 to 79 years. Video rasterstereography provides an easy access to multivariate analysis procedures and is established as a valid method for a three-dimensional spinal form assessment. ![]() Multivariate approaches should probably be able to identify effects that could have been covered in univariate analyses by variable interdependencies. Furthermore, univariate analyses based on back surface examinations reported inconclusive results for low back pain-associated spine shape parameters, although reliability of those methods was proved. A limited reliability of radiographic examinations, intraindividual variations in repeated measurements as well as multifactorial and individual influences on the sagittal spinal alignment should be taken into account while judging those results. However, controversy exists on this potential association, and-despite clinical relevance-specific X-ray patterns between acute and chronic low back pain patients could not be identified for the lumbosacral transition. Some radiological findings in adults confirmed a flatter lumbar lordosis to be associated with chronic low back pain. When the most predictive factor for the development of low back pain-earlier back pain periods-could be controlled statistically, a flatter lumbar lordosis angle could be identified as a risk factor mathematical modeling studies reported a tendency for a flatter lordosis angle in chronic low back pain patients, too. Especially, frontal plane spinal asymmetries were identified to be a risk factor for low back pain syndromes. In the past, beside psychosocial components and physical activity items, also anthropometric factors could be established to be influencing factors for the development of low back pain. ![]()
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