Radiological characteristics of lumbar vertebrae in patients with low back pain and change of motor control of the muscles of the lumbopelvic region

Background. Asymmetry of facets orientation and facets tropism of the lumbar zygoapophyseal joints is considered as one of the risk factors for developmental degenerative diseases of the spine. However, publications on asymmetry of articular facets in patients with low back pain and changes of motor stereotype were not found in the available literature. Purpose – is a comparative study of X-ray anatomical features of the lumbar vertebrae in patients with low back pain and impaired motor control of the muscles of the lumbopelvic region and asymptomatic volunteers. Materials and Methods. Design: a retrospective controlled study. Material: radiologic and MRI protocols of 30 asymptomatic volunteers aged 20–30 years (control group) and 60 patients aged 20–40 years with lumbar osteochondrosis and moderate pain syndrome and changes in motor control (main group). Methods: radiographic with assessment of: a) the size of the transverse processes and position of the spinous processes one of the L3, L4, L5 vertebrae; b) the size of the articular processes, the shape of their articular facets at the levels of L3–L4; L4–L5; L5–S1; radiometric with determination of: a) the orientation angles of the facets of the right (α) and left (β) zygoapophyseal joints; b) facet tropism; statistical. Results. According to the radiometric studies, a tendency towards sagittalization of the zygoapophyseal joints in the caudal direction was observed in both groups. The value of facet tropism for volunteers and patients was: in L3–L4 segment: (4.0 ± 0.9)º and (6.9 ± 1.1)º, respectively; in L4–L5 (4.4 ± 1.0)º one and (7.1 ± 1.2)º, respectively (p < 0.05); in L5–S1 segment (4.1 ± 1.1)º and (7.3 ± 1.4)º, respectively (p < 0.05). In the volunteer group, on all three lumbar segments FOright>FOleft, which contributes to a relatively uniform distribution of external loads between the elements of the segment. In the patient group, at the levels L3–L4 and L5–S1 FOrightFOleft, which, under the condition of reliably more frequent FT, can be accompanied by a slight but multidirectional shift of the instantaneous center of rotation of each of the vertebrae with an increase in the stress action of external forces constant for the spinal column, as well as a change in the activation time of the right and left eponymous deep muscles of the lumbar spine. Conclusions. Compared with volunteers, patients with changes in motor control of the muscles of the lumbopelvic region significantly more often have: asymmetry of the transverse processes of L4 (p < 0.05), L5 vertebrae (p < 0.01); rotation of the spinous processes of L3, L4 vertebrae (p < 0.001), asymmetry of the articular processes, incongruence of the articular facets in L3–L4 (p < 0.001) and L4–L5 (p < 0.001) segments, tropism anomaly in the L5–S1 segment.