MRI-derived lumbo-pelvic angles and lumbar discopathy in adults with low back pain from the Gaza Strip: a cross-sectional study

ObjectiveTo examine the association between lumbo-pelvic angles (LPAs) and Magnetic Resonance Imaging (MRI) detected discopathy in adults with low back pain (LBP) in the Gaza Strip and to establish local reference values for LPA measurements. MethodologyProspective cross-sectional study, 200 adults with LBP referred for lumbosacral MRI at two major hospitals in Gaza Strip. 1.5T MRI scanners were used, and Lumbar lordosis angle (LLA), sacral kyphosis angle (SKA) and sacral table angle (STA) were measured on mid-sagittal T2 images. Discopathy characteristics were recorded, and disability was assessed using the Oswestry Disability Index. ResultOf the 200 participants (mean age 45.7{+/-}13.6 years; 52.5% male), discopathy was most common at L4/L5 (89.5%), L5/S1 (67%) and L3/L4 (40.5%). LPAs were not significantly associated with discopathy involvement, type or severity, except for SKA discopathy severity at L3/4 (p=0.044). LPA measures were consistent across age groups, though LLA and STA were lower in males (p<0.001 and p=0.008), and obese individuals had higher LLA than those of normal weight (p=0.004). Reference LPA values were established stratified by LBP duration, in acute, subacute and chronic LBP, indicating a negative correlation between LLA and SKA in moderate and chronic duration. ConclusionIn adults with LBP in Gaza Strip, MRI-derived LPA showed limited association with lumbar discopathy characteristics, pain duration or disability. Although small differences related to gender, BMI and a single disc level were observed, overall associations were weak. The study establishes population-specific reference values for LPAs, which should be interpreted cautiously within a broader clinical context.