Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

다국어 초록 (Multilingual Abstract)

Study Design: Retrospective.
Purpose: This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.
Overview of Literature: Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.
Methods: We examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).
Results: Fifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.
Conclusions: Age, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results.

참고문헌 (Reference)

1 Leila Ghadyani, "Work-Related Low Back Pain Treatment: A Randomized Controlled Trial from Tehran, Iran, Comparing Multidisciplinary Educational Program versus Physiotherapy Education" 대한척추외과학회 10 (10): 690-696, 2016

2 Gasenzer ER, "The unforgettable neurosurgical operations of musicians in the last century" 101 : 444-450, 2017

3 Karademir M, "The importance of the sagittal balance of the spine and spino-pelvic paramaters" 25 : 139-148, 2014

4 Ozturk C, "The impact of L5 dorsal root ganglion degeneration and Adamkiewicz artery vasospasm on descending colon dilatation following spinal subarachnoid hemorrhage: an experimental study; first report" 6 : 69-75, 2015

5 Il Youp Cho, "The Effect of Standing and Different Sitting Positions on Lumbar Lordosis: Radiographic Study of 30 Healthy Volunteers" 대한척추외과학회 9 (9): 762-769, 2015

6 Kanat A, "Spinal surgery and neurosurgeon: quo vadis?" 57 : 75-79, 2013

7 Oltulu I, "Should we measure pelvic ıncidence via manually or computer assisted?" 25 : 183-187, 2014

8 Atici Y, "Sagittal plane analysis of the spine" 25 : 149-154, 2014

9 Ozdemir B, "Restoration of anterior vertebral height by short-segment pedicle screw fixation with screwing of fractured vertebra for the treatment of unstable thoracolumbar fractures" 99 : 409-417, 2017

10 Abdulbari Bener, "Prevalence and Correlates of Low Back Pain in Primary Care: What Are the Contributing Factors in a Rapidly Developing Country" 대한척추외과학회 8 (8): 227-236, 2014

11 Seiji Ohtori, "PainVision Apparatus Is Effective for Assessing Low Back Pain" 대한척추외과학회 8 (8): 793-798, 2014

12 Nishant, "New Modified English and Hindi Oswestry Disability Index in Low Back Pain Patients Treated Conservatively in Indian Population" 대한척추외과학회 8 (8): 632-638, 2014

13 Kanat A, "Neglected knowledge: Asymmetric features of lumbar disc disease" 12 : 199-202, 2017

14 Hong CH, "Measurement of the normal lumbar intervertebral disc space using magnetic resonance imaging" 4 : 1-6, 2010

15 Demirel N, "Measurement of spinal curvature angles on adults" 27 : 9-12, 2016

16 Al-Saeed O, "Magnetic resonance imaging of the lumbar spine in young arabs with low back pain" 6 : 249-256, 2012

17 Hiroaki Hagiwara, "Magnetic Resonance Imaging Evaluation of L5–S1 Intervertebral Disc Degeneration in Japanese Women" 대한척추외과학회 8 (8): 581-590, 2014

18 Zohreh Habibi, "Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases" 대한척추외과학회 8 (8): 813-819, 2014

19 Duzkalır HG, "Lumbar lordosis and sacral slope angles measurements according to age groups: a morphometric study" 26 : 107-111, 2015

20 Saleem S, "Lumbar disc degenerative disease: disc degeneration symptoms and magnetic resonance image findings" 7 : 322-334, 2013

21 Santosh Baliga, "Low Back Pain: Current Surgical Approaches" 대한척추외과학회 9 (9): 645-657, 2015

22 Ayhan Kanat, "Introducing a New Risk Factor for Lumbar Disc Herniation in Females : Vertical Angle of the Sacral Curvature" 대한신경외과학회 52 (52): 447-451, 2012

23 Balik MS, "Inequality in leg length is important for the understanding of the pathophysiology of lumbar disc herniation" 7 : 87-90, 2016

24 신병준, "How Does Chronic Back Pain Influence Quality of Life in Koreans: A Cross-Sectional Study" 대한척추외과학회 8 (8): 346-352, 2014

25 Sedigheh-Sadat Mirbagheri, "Evaluating Kyphosis and Lordosis in Students by Using a Flexible Ruler and Their Relationship with Severity and Frequency of Thoracic and Lumbar Pain" 대한척추외과학회 9 (9): 416-422, 2015

26 Kasım E, "Does short segment lumbar stabilization and fusion accelerate adjacent upper segment instability" 24 : 117-122, 2013

27 Akca N, "Describing a new syndrome in L5-S1 disc herniation: sexual and sphincter dysfunction without pain and muscle weakness" 5 : 146-150, 2014

28 Kenji Endo, "Characteristics of Sagittal Spino-Pelvic Alignment in Japanese Young Adults" 대한척추외과학회 8 (8): 599-604, 2014

29 Roma Satish Mehta, "Assessment of Lumbar Lordosis and Lumbar Core Strength in Information Technology Professionals" 대한척추외과학회 10 (10): 495-500, 2016

30 Parisa Azimi, "An Outcome Measure of Functionality and Pain in Patients with Low Back Disorder: A Validation Study of the Iranian version of Low Back Outcome Score" 대한척추외과학회 10 (10): 719-727, 2016