Objective: To investigate the relationship between commonly used radiologic parameters and occurrence of low back pain (LBP) through prospective study using pre-employment radiologic examination in high risk workplace.

Method: One hundred and fifty four male workers in high risk workplace were evaluated. Lumbar lordosis, lumbosacral angle, lumbar gravity line and lumbar disc height- related parameters were measured using simple radiologic films of lateral lumbosacral view taken during pre-employment medical check. Relationship between occurrence of LBP during post-employment period with a mean 1.7⁑1.0 years and radiologic parameter was investigated.

Results: Lumbar lordosis, lumbosacral angle and lumbar disc height were not significantly correlated to the occurrence of LBP. Amount of anterior shift of lumbar gravity line did not showed correlation to occurrence of LBP, but subjects with posterior displacement of lumbar gravity line showed significantly low rate of occurrence of LBP.

Conclusion: These results suggest that commonly used radiologic parameters are not so useful to predict occurrence of LBP in high risk workers. The possibile preventive effect of posterior shift of lumbar gravity line seems to be worth further researching. (J Korean Acad Rehab Med 2002; 26: 67-72)

The purposes of this study were to identify lumbar lordosis in low back pain patients and to investigate differences in lumbar lordosis in low back pain patients according to etiologies.

On the basis of the findings of spinal roentgenogram, MRI, and SPECT imagies, the patients were divided into four groups; 1) facet syndrome with facet joint inflammation or degenerative change, 2) disc herniation including disc bulging or extrusion, 3) combined low back pain accompaning facet joint lesion with disc herniation, 4) simple low back pain with no abnormal imaging findings.

There were statistically significant decrease in low back pain patients compared with normal controls in terms of lumbosacral curvature. No sex and age differences were observed within low back pain patients and normal controls in terms of lumbosacral curvature. The review disclosed a significant decrease of the lumbosacral angle in order of simple low back pain, disc herniation, combined low back pain compared with normal controls. But facet syndrome patients showed no change of lumbosacral angle. Patients with disc bulging showed no significant decrease of lumbosacral angle compared with normal controls but patients with disc extrusion showed significant decrease.

It is believed that the decrease of lumbosacral angle in low back patients results from a pathokinesiological effort to keep facet joint from pressure stemed from facet overlying and to minimize the shearing force over lumbosacral joint. The facet joint stiffness due to inflammation may play a major role in no change of lumbosacral angle in facet syndrome patients. In conclusion, different causes of low back pain should be taken into consideration for the assessment of lumbosacral angle.