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. 2019 Sep 24;55(10):627.
doi: 10.3390/medicina55100627.

Correlation of Body Mass Index with Pelvis and Lumbar Spine Alignment in Sagittal Plane in Hemophilia Patients

Klaudia Zawojska  1 , Agnieszka Wnuk-Scardaccione  2 , Jan Bilski  3 , Ewa Nitecka  4
Affiliations

Correlation of Body Mass Index with Pelvis and Lumbar Spine Alignment in Sagittal Plane in Hemophilia Patients

Klaudia Zawojska et al. Medicina (Kaunas). .

Abstract

Introduction: Concern about weight gain among people has been high due to negative health consequences in addition to the increasing prevalence of the problem. Overweight and obesity also occur in patients with hemophilia. Analysis of literature shows that increased body weight might have a biomechanical effect on the spatial orientation of the pelvis and the lumbar spine. The aim of this study was to determine the correlation between body mass index (BMI) and the parameters characterizing the alignment of the sacrum (SS, sacral slope), the pelvis (PT, pelvic tilt; PI, pelvic incidence) and the angle value of lumbar lordosis (LL, lumbar lordosis) assessed in the sagittal plane among patients with hemophilia. Materials and methods: A total of 49 patients were subjected to the study, 23 of whom met the inclusion criteria. Body weight and height were measured. Measurement of the angle values of indicators characterizing the position of the lumbar-pelvic complex was established based on X-ray imaging analysis. Results: Analysis of the correlation between the BMI and sacral, pelvic, and lumbar indicators evaluated in the sagittal plane in the study group of patients with hemophilia showed a correlation between BMI and SS (r = 0.48). SS values were significantly and positively related to PI (r = 0.6; p = 0.002) and LL (r = 0.46; p = 0.02). The results obtained indicate the BMI relationship with the setting of the sacrum in the sagittal plane (SS). After adjusting for the knee flexion contracture, the correlation on the border of significance (b = 0.73, p = 0.07) between the body mass index and the spatial orientation of the pelvis and the spine was revealed. Conclusion: We hypothesize that increased body weight among people with hemophilia might have an effect on the positioning of the lumbosacral region. Therefore, it is believed that preventing obesity among people with hemophilia can contribute to a smaller number of intra-articular hemorrhages and better orthopedic condition of the limb joints, and thus could avoid changes in the lumbosacral region as well as their consequences.

Keywords: body mass index; hemophilia; hemophilic arthropathy; lumbar-pelvic complex; spinopelvic alignment.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Method of plotting of the angle denoting: A—the sacral slope (SS) in the sagittal plane; B—the pelvic tilt (PT) in the sagittal plane; C—the pelvic incidence (PI) in the sagittal plane; D—the value of curvature of the lumbar spine (lumbar lordosis, LL) in the sagittal plane. Source: archive of own images.
Figure 1
Figure 1
Method of plotting of the angle denoting: A—the sacral slope (SS) in the sagittal plane; B—the pelvic tilt (PT) in the sagittal plane; C—the pelvic incidence (PI) in the sagittal plane; D—the value of curvature of the lumbar spine (lumbar lordosis, LL) in the sagittal plane. Source: archive of own images.
Figure 2
Figure 2
Scatter plot showing the relationship between BMI and the sacral slope (SS) in hemophilia patients.
See this image and copyright information in PMC

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