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Review
. 2022 Mar 20;12(3):457.
doi: 10.3390/life12030457.

Comparison of In Vivo Intradiscal Pressure between Sitting and Standing in Human Lumbar Spine: A Systematic Review and Meta-Analysis

Jia-Qi Li  1 , Wai-Hang Kwong  1 , Yuk-Lam Chan  1 , Masato Kawabata  2
Affiliations
Review

Comparison of In Vivo Intradiscal Pressure between Sitting and Standing in Human Lumbar Spine: A Systematic Review and Meta-Analysis

Jia-Qi Li et al. Life (Basel). .

Abstract

Background: Non-specific low back pain (LBP) is highly prevalent today. Disc degeneration could be one of the causes of non-specific LBP, and increased intradiscal pressure (IDP) can potentially induce disc degeneration. The differences in vivo IDP in sitting and standing postures have been studied, but inconsistent results have been reported. The primary objective of this systematic review is to compare the differences in vivo IDP between sitting and standing postures. The secondary objective of this review is to compare effect size estimates between (1) dated and more recent studies and (2) healthy and degenerated intervertebral discs.

Methods: An exhaustive search of six electronic databases for studies published before November 2021 was conducted. Articles measuring in vivo IDP in sitting and standing postures were included. Two independent researchers conducted the screening and data extraction.

Results: Ten studies that met the inclusion criteria were included in the systematic review, and seven studies with nine independent groups were included in meta-analyses. The sitting posture induces a significantly higher IDP on the lumbar spine (SMD: 0.87; 95% CI = [0.33, 1.41]) than the standing posture. In studies published after 1990 and subjects with degenerated discs, there are no differences in vivo IDP between both postures.

Conclusions: Sitting causes higher loads on the lumbar spine than standing in the normal discs, but recent studies do not support this conclusion. Furthermore, the degenerated discs showed no difference in IDP in both postures.

Keywords: in vivo measure; intradiscal pressure; low back pain; posture.

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Conflict of interest statement

The authors declare no competing financial or non-financial interests.

Figures

Figure 1
Figure 1
Flow diagram showing the selection of studies.
Figure 2
Figure 2
Effect of sitting compared to standing in IDP outcomes.
Figure 3
Figure 3
Results of the trial sequential analysis of the effect of sitting compared to standing in IDP outcomes.
Figure 4
Figure 4
Funnel plot of the standard errors of each study against the standardized mean difference.
Figure 5
Figure 5
Leave-one-out sensitivity analysis of the impact of posture on IDP.
Figure 6
Figure 6
Subgroup analysis according to publication years for IDP difference between sitting and standing postures.
Figure 7
Figure 7
Subgroup analysis according to disc conditions for IDP difference between sitting and standing postures.
Figure 8
Figure 8
Subgroup analysis according to disc levels for IDP difference between sitting and standing postures.
Figure 9
Figure 9
Meta-regression of the effect of posture according to the year of publication.
See this image and copyright information in PMC

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