A study published ahead of print in the European Spine Journal suggests that lumbar kyphosis, poor sagittal balance, and decreased back muscle strength are important risk factors for gastro-oesophageal disease.
The 245 participants (100 men and 145 females) in their study were healthy volunteers who had an average age of 66.7 years. Imagama et alassessed them using lumbar lateral standing radiographs, SpinalMouse (Idiag), which is an electronic computer-aided device that non-invasively measures sagittal spinal range of motion (ROM) and intersegmental angles, and the Frequency Scale for Symptoms of GORD (FSSG) questionnaire to detect the presence of GORD. They also reviewed body mass index (BMI), the presence of osteoporosis, back muscle strength, number of oral drugs taken per day, non-steroidal anti-inflammatory drugs (NSAIDs) intake, intake of bisphosphonates, and smoking and alcohol intake.
Imagama et al found that the lumbar lordosis angle, back muscle strength, and sacral inclination angle were significantly smaller in participants with GORD (60 overall; score of ≥8), but also found that the thoracic/lumbar angle (T/L) ratio and the number of drugs taken per day were significantly larger in this group. They did not find any differences between participants with GORD and those without GORD in terms of BMI, osteoporosis, thoracic kyphosis angle, spinal ROM, intake of oral NSAIDs, oral bisphosphonates, and smoking and alcohol history. Using a multivariate analysis, Imagama et al found that reduced lumbar lordosis was the most significant risk factor for development of acid reflux symptoms. They wrote: “Every additional one degree of lumbar kyphosis increased the chance of having GORD (acid reflux) by approximately 1.1, indicating a 2.59 times higher risk of GORD (acid reflux) development with a decrease of lumbar lordosis of 10 degrees.”
They added that their study is the first to show a relationship between reduced back muscle strength and the incidence of GORD, but explained that a previous study of theirs did show that improved back muscle strength was an “important factor for maintaining the lumbar lordosis angle and spinal sagittal balance.” They said: “Therefore, it is likely that decreased back muscle strength will lead to a lumbar kyphosis, a bent-forward posture and an increase in intra-abdominal pressure, resulting in GORD (acid reflux).”
Lumbar kyphosis, or backwards curve in the low back portion of the spine, has been implicated in a number of non-spinal issues, including uterine prolapse, rectal prolapse, irritable bowel syndrome, hemorrhoids, and now acid reflux. Non-surgical spinal correction can be a viable option for people who’ve been taking medication upon medication for these problems, or have had surgeries to correct prolapses, yet the prolapse simply recurred.
Source: Spinal News International
