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Hyperlordosis is associated with facet joint pathology at the lower lumbar spine


Jentzsch, Thorsten; Geiger, James; König, Matthias A; Werner, Clément M L (2017). Hyperlordosis is associated with facet joint pathology at the lower lumbar spine. Journal of Spinal Disorders & Techniques, 30(3):129-135.

Abstract

STUDY DESIGN:: A retrospective study.
OBJECTIVE:: Our study opted to clarify the remaining issues of lumbar lordosis (LL) in regard to (1) its physiologic values, (2) age, (3) gender, (4) facet joint (FJ) arthritis and orientation using CT scans.
SUMMARYOF BACKGROUND DATA:: Recent studies have questioned whether LL really decreases with age, but study sample sizes have been rather small and mostly been based on X-rays. Since hyperlordosis increases the load transferred through the FJs, it seems plausible that hyperlordosis may lead to FJ arthritis at the lower lumbar spine.
METHODS:: We retrospectively analyzed CT scans of 620 individuals, with a mean age of 42.5 (range, 14-94) years, who presented to our traumatology department and underwent a whole body CT scan, between 2008 and 2010. LL was evaluated between the superior endplates of L1 and S1. FJs of the lumbar spine were evaluated for arthritis and orientation between the L2 and S1.
RESULTS:: (1) The mean LL was 49.0° (SD 11.1°, range 11.4-80.1°). (2) LL increased with age and there was a significant difference in LL in our age groups (≤30, 31-50, 51-70 and ≥71 y) (P=0.02). (3) There was no significant difference in LL between females and males (50° and 49°) (P=0.17). (4) LL showed a significant linear association with FJ arthritis (P=0.0026, OR=1.022 [1.008-1.036]) and sagittal FJ orientation at L5/S1 (P=0.001). In a logistic regression analysis the cut-off point for LL was 49.4°.
CONCLUSION:: This is the largest CT-based study on LL and FJs. LL significantly increases with age. As a novelty finding, hyperlordosis is significantyly associated with FJ arthritis and sagittal FJ orientation at the lower lumbar spine. Thus hyperlordosis may present with back pain and patients may benefit from surgical correction, for example in the setting of trauma.

Abstract

STUDY DESIGN:: A retrospective study.
OBJECTIVE:: Our study opted to clarify the remaining issues of lumbar lordosis (LL) in regard to (1) its physiologic values, (2) age, (3) gender, (4) facet joint (FJ) arthritis and orientation using CT scans.
SUMMARYOF BACKGROUND DATA:: Recent studies have questioned whether LL really decreases with age, but study sample sizes have been rather small and mostly been based on X-rays. Since hyperlordosis increases the load transferred through the FJs, it seems plausible that hyperlordosis may lead to FJ arthritis at the lower lumbar spine.
METHODS:: We retrospectively analyzed CT scans of 620 individuals, with a mean age of 42.5 (range, 14-94) years, who presented to our traumatology department and underwent a whole body CT scan, between 2008 and 2010. LL was evaluated between the superior endplates of L1 and S1. FJs of the lumbar spine were evaluated for arthritis and orientation between the L2 and S1.
RESULTS:: (1) The mean LL was 49.0° (SD 11.1°, range 11.4-80.1°). (2) LL increased with age and there was a significant difference in LL in our age groups (≤30, 31-50, 51-70 and ≥71 y) (P=0.02). (3) There was no significant difference in LL between females and males (50° and 49°) (P=0.17). (4) LL showed a significant linear association with FJ arthritis (P=0.0026, OR=1.022 [1.008-1.036]) and sagittal FJ orientation at L5/S1 (P=0.001). In a logistic regression analysis the cut-off point for LL was 49.4°.
CONCLUSION:: This is the largest CT-based study on LL and FJs. LL significantly increases with age. As a novelty finding, hyperlordosis is significantyly associated with FJ arthritis and sagittal FJ orientation at the lower lumbar spine. Thus hyperlordosis may present with back pain and patients may benefit from surgical correction, for example in the setting of trauma.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:27 September 2017
Deposited On:12 Dec 2013 15:14
Last Modified:19 Feb 2018 07:18
Publisher:Lippincott, Williams & Wilkins
ISSN:1536-0652
Additional Information:This is a non-final version of an article published in final form in Journal of Spinal Disorders & Techniques.
OA Status:Green
Publisher DOI:https://doi.org/10.1097/BSD.0b013e3182aab266
PubMed ID:24077414

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