The lumbosacral angle describes the degree between the lumbar and sacral portions of the spine. It can have an impact on back pain and on the risk of a slipped disc in the lower back.
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Quick Spinal Anatomy Review
The entirety of the spine from the neck down through L5, the lowest lumbar vertebra, rests on the top ofthe sacrum. This bottom joint, L5 - S1, is also known as thelumbosacral joint.
Cervical Spine Curve and Injuries
The Lumbosacral Angle Defined
Your whole spine sits on top of the lowest sacrum bone. The top of the sacrum bone is called the sacral base and it is not horizontal—rather, it tilts at an angle. The degree of sacral base tilt varies between individuals and can range between steep and flat.
As the base of support for the spine, this sacral angle determines, at least in part, the degree of curve in the lumbar, thoracic and cervical areas. Starting at the foundation at the top of the sacrum and going up the spine, one angle influences another.
The Lumbosacral Angle and Spondylolisthesis
One common spinal problem,spondylolisthesis, can affect the spine at any level. It is one of the common problems at the L5-sacrum joint. Spondylolisthesis is forward slippage of the top bone, the L5, relative to the bottom bone, the sacrum.
This condition can occur at any age, but the cause at each age differs.
These changes and injuries can affect anyone, and the lumbosacral angle may have some effect on the risk. A study published in 2020 showed that a steeper tilt of the lumbosacral angle was associated with a higher risk of disc slippage of the lower spine.
Lumbosacral Joint (L5-S1): Anatomy and Pain Symptoms
Can Exercise Improve a Lumbosacral Angle?
If you have back pain, you may be wondering if it’s possible to correct an excessive lumbosacral angle with exercise.
A 2018 study published in theJournal of Physical Therapy Sciencelooked at the results of a twelve-week lumbar stabilization exercise program.
The researchers found that while the program helped strengthen core muscles, i.e., those muscles most responsible for stabilizing the spinal column, especially in the upright position, it did not actually alter the lumbosacral angle.The study authors surmise that the reduction in pain after the twelve weeks of work was likely due to increased muscle strength and joint flexibility, lessening the load placed on the spine.
For people who have high-grade spondylolisthesis, surgical reduction of the angle may reduce the risk of slippage.But this is major surgery, and the procedure has risks, so it is not typically considered an option in terms of risks and benefits unless there are severe symptoms.
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3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zheng S, Zhong Z, Zhu Q, Li Z, Zhu S, Yao X, Zheng S, Liao C, Zhu Y, Chen J.Straighter low lumbar curvature in isthmic spondylolisthesis at L4.BMC Musculoskelet Disord. 2020 Jul 22;21(1):483. doi:10.1186/s12891-020-03519-4Ko KJ, Ha GC, Yook YS, Kang SJ.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain.J Phys Ther Sci. 2018 Jan;30(1):18-22. doi:10.1589/jpts.30.18Amritanand R, Arockiaraj J, David KS, Krishnan V.Does the surgical reduction of high grade spondylolisthesis restore spino-pelvic alignment? An analysis of 35 patients.Asian Spine J.2021 Oct;15(5):596-603. doi:10.31616/asj.2020.0252Additional ReadingSources:Calliet, R., M.D., The Illustrated Guide to Functional Anatomy of the Musculoskeletal System. American Medical Association Press. USA. 2004.H. Hosoe, et. al.Possible Factors which Predispose the Fifth Lumbar Vertebra to Slip. The Journal of the Bone and Joint Surgery. March 2008.Ko, K., PhD. et. al.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain. J Phys Ther Sci. Jan 2018.doi:10.1589/jpts.30.18
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zheng S, Zhong Z, Zhu Q, Li Z, Zhu S, Yao X, Zheng S, Liao C, Zhu Y, Chen J.Straighter low lumbar curvature in isthmic spondylolisthesis at L4.BMC Musculoskelet Disord. 2020 Jul 22;21(1):483. doi:10.1186/s12891-020-03519-4Ko KJ, Ha GC, Yook YS, Kang SJ.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain.J Phys Ther Sci. 2018 Jan;30(1):18-22. doi:10.1589/jpts.30.18Amritanand R, Arockiaraj J, David KS, Krishnan V.Does the surgical reduction of high grade spondylolisthesis restore spino-pelvic alignment? An analysis of 35 patients.Asian Spine J.2021 Oct;15(5):596-603. doi:10.31616/asj.2020.0252Additional ReadingSources:Calliet, R., M.D., The Illustrated Guide to Functional Anatomy of the Musculoskeletal System. American Medical Association Press. USA. 2004.H. Hosoe, et. al.Possible Factors which Predispose the Fifth Lumbar Vertebra to Slip. The Journal of the Bone and Joint Surgery. March 2008.Ko, K., PhD. et. al.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain. J Phys Ther Sci. Jan 2018.doi:10.1589/jpts.30.18
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zheng S, Zhong Z, Zhu Q, Li Z, Zhu S, Yao X, Zheng S, Liao C, Zhu Y, Chen J.Straighter low lumbar curvature in isthmic spondylolisthesis at L4.BMC Musculoskelet Disord. 2020 Jul 22;21(1):483. doi:10.1186/s12891-020-03519-4Ko KJ, Ha GC, Yook YS, Kang SJ.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain.J Phys Ther Sci. 2018 Jan;30(1):18-22. doi:10.1589/jpts.30.18Amritanand R, Arockiaraj J, David KS, Krishnan V.Does the surgical reduction of high grade spondylolisthesis restore spino-pelvic alignment? An analysis of 35 patients.Asian Spine J.2021 Oct;15(5):596-603. doi:10.31616/asj.2020.0252
Zheng S, Zhong Z, Zhu Q, Li Z, Zhu S, Yao X, Zheng S, Liao C, Zhu Y, Chen J.Straighter low lumbar curvature in isthmic spondylolisthesis at L4.BMC Musculoskelet Disord. 2020 Jul 22;21(1):483. doi:10.1186/s12891-020-03519-4
Ko KJ, Ha GC, Yook YS, Kang SJ.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain.J Phys Ther Sci. 2018 Jan;30(1):18-22. doi:10.1589/jpts.30.18
Amritanand R, Arockiaraj J, David KS, Krishnan V.Does the surgical reduction of high grade spondylolisthesis restore spino-pelvic alignment? An analysis of 35 patients.Asian Spine J.2021 Oct;15(5):596-603. doi:10.31616/asj.2020.0252
Sources:Calliet, R., M.D., The Illustrated Guide to Functional Anatomy of the Musculoskeletal System. American Medical Association Press. USA. 2004.H. Hosoe, et. al.Possible Factors which Predispose the Fifth Lumbar Vertebra to Slip. The Journal of the Bone and Joint Surgery. March 2008.Ko, K., PhD. et. al.Effects of 12-week lumbar stabilization exercise and sling exercise on lumbosacral region angle, lumbar muscle strength, and pain scale of patients with chronic low back pain. J Phys Ther Sci. Jan 2018.doi:10.1589/jpts.30.18
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