Published: 2017-01-02

Evaluation of lumbar angles and their clinical correlates in a Nigerian population

Ndubuisi O. C. Onyemaechi


Background: There is paucity of data on the geometric angles of the lumbosacral spine in Nigeria and other African countries. The objective was to study the lumbar angles in our population and causes of variations if any.

Methods: The lateral views of the lumbosacral spine radiographs of 300 Nigerian subjects were studied. The lumbar angles measured were lumbosacral angle (LSA), Lumbar lordosis angle (LLA), Sacral inclination angle (SIA) and lumbosacral disc angle (LSDA). The demographics and anthropometric measurements of the subjects such as weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC) and waist-hip ratio (WHR) were also recorded.

Results: The mean values of the angles were as follows: LSA=37.80±9.20; LLA=40.40±11.20; SIA=38.70±8.90 and LSDA=14.60±3.40. There was a positive correlation between the weight, BMI, HC and WC of the subjects and LSA. A significant association was noted between the height, weight, BMI, HC, WC and WHR of the subjects and LLA. Whereas SIA was significantly affected by sex, weight, BMI, HC and WC of the subjects, LSDA was determined by age, BMI, WC and WHR.

Conclusion: The mean values of these angles may form the reference values for the Nigerian population. Overweight and obesity were associated with increased lumbar angles.


Lumbar angles, Evaluation, Anthropometry, Nigeria

Full Text:



Gelb DE, Lanke LG, Bridwell KH, Blanke K, McEnery KW. An Analysis of Sagittal spine alignment in 100 asymptomatic middle aged and older volunteers. Spine. 1995;20:1351-8.

Azar MS, Talebpour F, Alaee AR, Hadinejad A, Sajadi M, Nozari A. Association of low back pain with Lumbar Lordosis and Lumbosacral Angle. Mazand University Medical Science. 2009;20(75):915.

Evcik D, Yucel A. Lumbar Lordosis in acute and chronic low back pain patients. Rheumatol. 2003;23:163-5.

Sarikaya S, Ozdolap S, Gumustas S, Koc U. Low back pain and Lumbar angles in Turkish coal miners. Am J. Ind. Med. 2007;50:92-6.

Lord MJ, Small JM, Dinsay JM, Watkins RG. Lumbar Lordosis. Effects of sitting and standing. Spine. 1997;22:2571-4.

Fernand R, Fox DE. Evaluation of Lumbar Lordosis: A prospective and retrospective study. Spine. 1985;10:799-803.

Bogduk N. Clinical Anatomy of the Lumbar Spine and Sacrum 4th Ed. London: Churchill Livingstone. 2005;100-25.

Middleditch A, Oliver J. Lumbar Spine. In: Functional Anatomy of the Spine 2nd Ed. Oxford: Butterworth-Heinemann. 1998;36-58.

Amonoo-Kuofi HS. Changes in the Lumbosacral Angle, Sacral inclination and Lumbar Spine during Ageing. Acta Anatomica 1992;145(4):373-7.

Zhou SH, McCarthy ID, McGregor AH, Coombs RRH, Hughes SPF. Geometrical dimensions of the lower Lumbar Vertebrae-analysis of data from digitized CT images. EUR Spine J. 2000;9:242-48.

Swank SM, Mauri TM, Brown JC. The Lumbar Lordosis below Harrington instrumentation for scoliosis. Spine. 1990;15:181-6.

Andrew R, Brafielf B, Mayes L, Russel T, Teel J. The effect of obesity on sacral base angle. Senior Research Project, Logan College of Chiropractic. 2001;1-14.

Naidoo M. The Evaluation of normal radiographic measurements of the lumbar spine in young and middle-age Indian females in Durban. Masters degree dissertation at Durban University of Technology. 2008;1-75.

Miyamoto M, Konno S, Gembun Y, Liu X, Minami K, Ito H. Epidemiological study of low back pain and occupational risk factors among taxi drivers. Industrial Health. 2008;46:112-7.

Chung HS, Lee HK, Kim HD, Chu JW. Plain roentgenographic findings on Lumbar Disc Herniation. Journal of Korean Neurosurgery Society 1981; 10(2): 557-68.

Kim HJ, Chung S, Kim S, Shin H, Lee J, Kim S, et al. Influences of trunk muscles on lumbar lordiosis and sacral angle. Eur Spine J. 2006;15(4):409-14.

Ridola C, Palma A, Ridola G, Sanfilippo A, Almasio PL, Zummo G. Changes in the Lumbosacral Segment of the spine due to overweight in adults. Preliminary remarks. Italian Journal of Anatomy and Embryology. 1994;99(3):133-43.

Braunaugh J, Jansen D, Levin J, Lippy J. A pilot study of the relationship between body mass index, waist to hip ratio and sacral base angle. Logan College of Chiropractic. 2002;1-12.

Farfan HF, Huberdeau RM, Dobow HI. Lumbar intervertebral Disc degeneration. Journal of Bone and Joint Surgery. 1972;54(A):492-509.

Chernukha KV, Paffner RH, Reigel DH. Lumbar Lordosis measurement – a new method versus Cobb Technique. Spine. 1998;23(1):74-80.

Korovessis PG, Stamatakis MV, Baikousis AG. Reciprocal angulation of vertebral bodies in the Sagittal Plane in an asymptomatic Greek population. Spine. 1998;23(6):700-5.

VonLackum HL. The lumbosacral region. An Anatomic Study and some Clinical Observations. JAMA. 1924;82(14):1109-14.

Nakipoglu GF, Karagoz A, Ozgirgin N. The biomechanics of the Lumbosacral Region in Acute and Chronic low back pain patients. Pain Physician 2008;11:505-11.

Yochum TR, Rowe LJ. Essentials of Skeletal Radiology Vol. 1, 3rd Ed. Williams and Wilkins, Philadelphia. 53-70.

Peleg S, Dar G, Medleji B, Steinberg N, Masharawi Y, Latimer B, et al. Orientation of the Human Sacrum: Anthropological Perspectives and Methodological approaches. Am Journal of Phy Anthrop. 2007;133:967-77.

Guo JM, Zhang GQ, Alimujiang. Effects of BMI and WHR on Lumbar Lordosis and sacrum slant angle in middle aged and elderly women. China Journal of Orthop and Traumat. 2008;21(1):30-1.

Hirano K, Imagama S, Hasegawa Y, Wakao N, Muramoto A, Ishiguro N. Impact of back muscle strength and ageing on locomotive syndrome in living Japanese women. Nagoya J Med Sci. 2013;75:47-55.

Banks SD. The use of Spinographic Parameters in the differential diagnosis of lumbar facet and disc syndromes. Journal of manipulative and physiological Therap. 1983;6(3):113-6.

Cox JM. Low back pain: Mechanisms, Diagnosis and Treatment. 6th Ed 1999. Baltimore: Williams and Wilkins. 480-512.

Peters RE. Facet Syndrome. Euro J. Chiropractic. 1984;32:40-2.