Here is a study Professionally Integrated would like you to have where the authors compared asymptomatic individuals and disc degeneration and sagittal alignment. The authors concluded that disc degeneration correlates with a loss of the lumbar lordosis. This to me explains why we need to work on the sagittal alignment and not just treat for symptoms. We have the tools to improve sagittal alignment and decrease arthritis. This is another example to validate our care and why we do what we do. Lets take a look at what the authors found in this study. Use this for patient education and put in your notes.
“Spinal sagittal balance is important with regard to the development of lumbar spine degeneration. The spinal sagittal balance can activate compensatory mechanisms in the degenerative spine such as reduction of thoracic kyphosis, intervertebral hyperextension, retrolisthesis, pelvis retroversion, knee flexion, and ankle extension.” Look at the negative effects a abnormal sagittal alignment has on our patients health!
“One clinically relevant finding of our study was that the type II sagittal alignment subtype was associated with a significantly higher frequency of degenerated discs” The type II sagittal alignment was a loss of lumbar lordosis.
“These authors found increased L4-L5 disc degeneration in the flat-back group compared with the hyperlordotic group.”
“Our result of a higher prevalence of L4-L5 disc degeneration in asymptomatic young adults with type II sagittal alignment supports the hypothesis that sagittal alignment plays an important role in disc degeneration.” If your patient has a loss of curve, we should treat them to prevent arthritis!
“When the lumbar spine is hypolordotic and flat, contact forces primarily act on the anterior region of the spine, vertebral bodies, and discs, thereby increasing disc pressure.”
“concluded that a decrease of 8 degrees in the lordotic curvature is sufficient to greatly increase mechanical stress on the intervertebral discs between L4 and S1.”
The spine alignment can be associated with the appearance of lumbar disc degeneration in young asymptomatic adults. Roussouly type II sagittal alignment is associated with early disc degeneration at the L4-L5 level. Spinopelvic parameters are correlated with the degree of degeneration in individuals with type II Roussouly.
SPINE Volume 41, Number 18, pp E1081–E1087 Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults.