PR_236: Lumbar Lordosis and Low Back Pain in Transfemoral Amputees

Abstract

Objectives: To document lumbar lordosis in transfemoral amputees and to determine whether excessive lordosis is related to low back pain (LBP). Design: A cross-sectional observational study. Setting: Tertiary care Veterans Administration medical center. Participants: Subjects consisted of 9 transfemoral amputees with LBP and 8 transfemoral amputees without LBP. Transfemoral amputees with LBP were defined as those subjects who answered yes to having persistent and bothersome LBP. Transfemoral amputees without LBP were defined as those who answered no. Transfemoral amputees with LBP had a mean age of 55 years, were 26 years postamputation, used their prosthesis 13h/d, and had an average LBP intensity of 5 on a scale of 0 to 10 over the last 3 months. Transfemoral amputees without LBP had a mean age of 48 years, were 21 years postamputation, used their prosthesis 14h/d, and had an average LBP intensity of 0 over the past 3 months. Amputations were traumatic in 62.5% of transfemoral amputees with LBP and 100% of transfemoral amputees without LBP. Interventions: Not applicable. Main Outcome Measures: L1-5 Cobb angles and pelvic inclination angles were measured from a lateral upright radiograph by an orthopedic spine surgeon, blinded to subjects’ pain status. Results: The mean L1-5 Cobb angle ± SD (range) were: 46°±12° (24°−62°) for transfemoral amputees with LBP; and 51°±13° (32°−70°) for transfemoral amputees without LBP. The unpaired t test for Cobb angle difference gave a P value of .433. The mean sacral inclination angles were: 38°±°9 (26°−48°) for transfemoral amputees with LBP; and 39°±8° (30°−47°) for transfemoral amputees without LBP. The unpaired t test for sacral inclination angle difference gave a P value of .845. Conclusions: No difference was found in L1-5 Cobb angles and sacral inclination angles among transfemoral amputees with and without LBP. However, one cannot exclude type 2 error.