Research article

The association of spinal osteoarthritis with lumbar lordosis

Michael Papadakis^1,2*, Georgios Papadokostakis³, Nikos Kampanis², Georgios Sapkas⁴, Stamatios A Papadakis⁵ and Pavlos Katonis⁶

• * Corresponding author: Michael Papadakis michalpap@gmail.com

Author Affiliations

¹ 2nd Department of Orthopaedic Surgery, University of Athens, Athens, Greece

² Institute of Applied and Computational Mathematics, Foundation of Research and Technology Hellas (IACM-FORTH), Heraklion, Greece

³ Georgios Papadokostakis, University Hospital of Heraklion, Heraklion, Greece

⁴ 1st department of Orthopaedic Surgery, University of Athens, Athens, Greece

⁵ 5th Department of Orthopaedic Surgery, "KAT" General Hospital, Athens, Greece

⁶ Pavlos Katonis, Department of Orthopaedic Surgery, University of Crete, Heraklion, Greece

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BMC Musculoskeletal Disorders 2010, 11:1 doi:10.1186/1471-2474-11-1

Published: 2 January 2010

Abstract

Background

Careful review of published evidence has led to the postulate that the degree of lumbar lordosis may possibly influence the development and progression of spinal osteoarthritis, just as misalignment does in other joints. Spinal degeneration can ensue from the asymmetrical distribution of loads. The resultant lesions lead to a domino- like breakdown of the normal morphology, degenerative instability and deviation from the correct configuration. The aim of this study is to investigate whether a relationship exists between the sagittal alignment of the lumbar spine, as it is expressed by lordosis, and the presence of radiographic osteoarthritis.

Methods

112 female subjects, aged 40-72 years, were examined in the Outpatients Department of the Orthopedics' Clinic, University Hospital of Heraklion, Crete. Lumbar radiographs were examined on two separate occasions, independently, by two of the authors for the presence of osteoarthritis. Lordosis was measured from the top of L₁ to the bottom of L₅ as well as from the top of L₁ to the top of S₁. Furthermore, the angle between the bottom of L₅ to the top of S₁was also measured.

Results and discussion

49 women were diagnosed with radiographic osteoarthritis of the lumbar spine, while 63 women had no evidence of osteoarthritis and served as controls. The two groups were matched for age and body build, as it is expressed by BMI. No statistically significant differences were found in the lordotic angles between the two groups

Conclusions

There is no difference in lordosis between those affected with lumbar spine osteoarthritis and those who are disease free. It appears that osteoarthritis is not associated with the degree of lumbar lordosis.