Asian Spine J.  2017 Oct;11(5):726-732. 10.4184/asj.2017.11.5.726.

Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

• Kazdal H
• Kanat A
• Batcik OE
• Ozdemir B
• Senturk S
• Yildirim M
• Kazancioglu L
• Sen A
• Batcik S
• Balik MS

• KMID: 2392655
• DOI: http://doi.org/10.4184/asj.2017.11.5.726

Abstract

STUDY DESIGN: Retrospective. PURPOSE: This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia. OVERVIEW OF LITERATURE: Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.
METHODS
We examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).
RESULTS
Fifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann-Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.
CONCLUSIONS
Age, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results.

Keyword

Caesarean section; Low back pain; Spinal anesthesia

MeSH Terms

Anesthesia, Spinal
Body Mass Index
Cesarean Section*
Consensus
Female
Humans
Low Back Pain*
Parity
Pregnancy
Prospective Studies
Retrospective Studies
Risk Factors*
Sacrum*