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Chiropractic Research Review

L1 Landmark Poor Judge of Lordosis?

The lumbar lordosis was roentgenomet-rically measured on 70 lateral lumbar radiographs to determine whether the choice of either the superior or inferior endplate of the L1 vertebra as the proximal landmark for the measurement of lumbar lordosis could significantly affect the categorization (i.e., hypo/hyperlordotic, or normal) of lordosis in subjects where the L1 vertebra was wedged anteriorly.

Seventy-three percent of the x-rays showed wedging of the L1 vertebra in excess of 2 mm.

The mean lumbar lordosis, measured using the superior endplate of L1 as the proximal boundary for measurement of the lordotic angle, was 52.0 +/- 11.82 degrees, and was significantly lower than the mean lumbar lordosis (59.06 +/- 12.01 degrees) measured using the inferior endplate of L1.

Results indicate that the choice of landmark (i.e., superior or inferior endplate of L1) can significantly affect the value of the lumbar lordosis angle and its subsequent categorization as hypo/hyperlordotic or normal in patients where this vertebra is wedged anteriorly. L1 might not necessarily represent the best choice of landmark for the measurement of lumbar lordosis.

Worrill NA, Peterson CK. Effect of anterior wedging of L1 on the measurement of lumbar lordosis: comparison of two roentgenological methods. Journal of Manipulative and Physiological Therapeutics, Sept. 1997;20(7), pp459-67. Reprints: Tel: (630) 889-6524; Fax: (630) 889-6482

Chiropractic Research Review

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