Flat Back (Lack of Lumbar Lordosis) and Disc Herniation
Lordosis, or the lack of it, has been thought to be a biomechanical precursor to disc herniation in the lumbar spine. To investigate this possible correlation, a group of researchers from Gothenburg University looked at sixteen young active young patients with a median age of 18yrs old who experienced a disc herniation and underwent discectomy surgery. 1
Lordosis is the curve in the lower back—which they measured before and after the surgery.
Researchers used the Roussouly 4-type classification system to measure the degree of lordosis in the lumbar spine.
The researchers found less lordosis in the subjects that had surgery for their disc herniation. In other words, disc herniation was twice as likely to be present in the group with a flatter back. All the disc herniations were found to be in the lowest two levels of the lumbar spine (L4-5 and L5-S1), consistent with other epidemiological studies. 2
Dynamic Disc Designs Models
At Dynamic Disc Designs Corp. we have worked to represent the anatomy accurately. Our Professional LxH Dynamic Disc Model is created with 12mm of disc height anteriorly and 10mm posteriorly providing a slight lordotic curve. Further, the model has been created with a higher percentage of nucleus pulposus which is often found in younger lumbar spines. To demonstrate that disc herniation occurs more likely with less lordosis all one has to do is dynamically move the single-level model into a less lordosis position and manually create compression. With more lordosis, the nucleus has a more difficult time penetrating through the outer annulus fissure. This can be an important posture teaching point in the prevention of disc herniation.
If you want to take your patient education to a dynamic level, explore what Dynamic Disc Designs models can do for you, your practice and ultimately, your patients.
- Beck J, Brisby H, Baranto A, Westin O. Low lordosis is a common finding in young lumbar disc herniation patients. J Exp Orthop. 2020;7(1):38. Published 2020 May 31. doi:10.1186/s40634-020-00253-7 ↩
- Mac-Thiong JM, Labelle H, Berthonnaud E, Betz RR, Roussouly P (2007) Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J 16:227–234. https://doi.org/10.1007/s00586-005-0013-8 ↩