Sagittal plane mal-alignment in lumbar spinal radiographs in a tertiary hospital

Abstract

Background: Plane radiograph of the spine is still the primary or first line investigation in patients with a variety of symptoms including back pain in a resource limited setting like ours.
Methods: A crosssectional study of radiographs of patients who were referred to Radiology Department of Jos University Teaching Hospital for lumbo-sacral radiography between July 2013 and April 2014 was carried out.
Results: Two hundred and forty two lumbo-sacral radiographs were assessed comprising 166 (68.6%) females and 76 (31.4%) males with a mean age of 48±15 years. Overall 15 (6.2%) patients were found with mal-alignment in the sagittal plane consisting 10 females and 5 males with a female to male ratio of 2:1. Anterolisthesis occurred in 11(4.5%) and retrolisthesis in 4 (1.7%). First degree slip dominated in 9/15 (60%) of the patients with listhesis, while second degree slip was found in 6 (40%). Most of the observed vertebral subluxation (7; 46.7%) occurred at the L4/L5 intervertebral disc space.
Conclusions: Mal-alignment in the sagittal plane in lumbar spine radiographs in our locality demonstrates comparable pattern and localization with that seen elsewhere.

Keywords: Lumbar Spine, Radiographs, Listhesis, Malalignment