Relationships among the lumbar lordosis index, sacral horizontal angle, and chronic low back pain in the elderly aged 60-69 years: A cross-sectional study.

BACKGROUND: Spinal sagittal imbalance caused by degenerative changes or iatrogenic factors in the elderly can cause symptoms such as anteversion and low back pain (LBP). There are different and conflicting opinions about the relationship between the degree of lumbar lordosis and functional status of patients with chronic low back pain (CLBP). OBJECTIVE: This study aimed to determine the relationships among the lumbar lordosis index, sacral horizontal angle, and CLBP in the elderly. METHODS: Subject data were collected from Lishui City, Zhejiang Province, China, using cluster sampling according to the background information provided by national physical fitness monitoring. The 207 subjects were urban and rural individuals, 60-69 years old. Radiographs were evaluated according to a standardized protocol. The lumbar lordosis index and sacral horizontal angle were recorded. Data on the prevalence and functional status of CLBP were collected through field investigations. Statistical correlations between the radiographic parameters and the prevalence and functional status of CLBP measurements were evaluated. RESULTS: No significant difference was observed in the sacral horizontal angles among the subjects with and without CLBP; however, the lumbar lordosis index of CLBP subjects was significantly higher than that of those without CLBP (P= 0.028) and showed a significant association with CLBP (P= 0.013). Neither the sacral horizontal angle nor the lumbar lordosis index showed significant correlations with the Oswestry Disability Index in CLBP subjects. CONCLUSIONS: The lumbar lordosis index, but not the sacral horizontal angle, was significantly associated with CLBP in the subjects.