The Influence Of Long-term Loading On Sagittal Spino-pelvic Morphology

Objective:To investigate the association between long-term loading and sagittal spino-pelvic parameters.Methods:We retrospectively reviewed56patients who suffered from back pain and performed long-standing lateral X-ray from January2012to December2013in outpatient and hospitalization department in SRRS hospital.31of them were farmers which had a long history of carrying loads over20years, while others were office workers which denied long-term loading history. All the patients were divided into group Loading and group Non-loading. Two researchers measured the following parameters independently and analyzed the results:thoracic kyphosis(TK), lumbar lordosis(LL), sacral slope(SS), pelvic incidence(PI) and pelvic tilt(PT).Results:Group Loading included8males and23females with the average age was69.8±5.8years and average weight was61.2±6kg. Group Non-loading included7males and18females with the average age68.6±3.8years and the average weight was59.6±7.5kg. The mean value of spino-pelvic parameters in group Loading were30.7±17.3degree for TK,31.2±14.5degree for LL,24.4±10.5degree for SS,45.8±12.3degree for PI and21.4±19.0degree for PT, while the mean value of spino-pelvic parameters in group Non-loading were19.4±6.3degree for TK,39.3±12.7 degree for LL,32.4±7.3degree for SS,48.3±10.6degree for PI and15.8±9.3, respectively. The comparison of gender, age and weight between two group were not significant (p>0.05). Results of comparison of spino-pelvic parameters showed that the TK and PT in group Loading were significant higher than the group Non-loading (p<0.05), while the LL and SS value were significant lower (p<0.05). The comparison of PI value was not significant between the two groups (p>0.05).Conclusions:Long-term loading tends to be one of the risk factors of pathological kyphosis and the spine and pelvis will compensate with lumbar lordosis loss and pelvic retroversion to keep the sagittal spino-pelvic balance.