Journal List > J Korean Soc Spine Surg > v.24(3) > 1076139

Lee, Lee, Park, Song, Yoon, Yeom, Lee, and Lee: Relationship Between Pelvic Tilt and Lumbar Disc Degeneration


Study Design

Retrospective analysis.


To determine the relationship between pelvic tilt and lumbar disc degeneration.

Summary of Literature Review

The shape and the spatial orientation of the pelvis determine the organization of the lumbothoracic spine. The purpose of our study was to determine the relationship between pelvic tilt and lumbar disc degeneration.

Materials and Methods

Sixty patients over 50 years of age who had undergone lumbar spine magnetic resonance imaging were recruited. In individuals between 41 and 60 years of age, the normal pelvic tilt is 14°. Patients were divided into a low pelvic tilt (PT) group (<14°) and a high pelvic tilt (PT) group (≥14°). Lumbar disc degeneration was graded from I to V according to the Pfirrmann grade. We defined grades IV and V as high-grade degeneration and the others as low-grade degeneration. Radiologic parameters and lumbar disc degeneration were compared between these 2 groups.


In the low PT group, the average degeneration grade of each lumbar segment was 2.61 in L1-L2, 2.61 in L2-L3, 3.00 in L3-L4, 3.39 in L4-L5, and 3.84 in L5-S1. The corresponding grades in the high PT group were 2.34 in L1-L2, 2.62 in L2-L3, 3.07 in L3-L4, 3.76 in L4-L5, and 3.55 in L5-S1. The grade of degeneration of the high PT group was significantly higher than that of the low PT group for L4-L5 (p=0.031). High-grade degeneration of the L4-L5 segment was significantly more common in the high PT group (odds ratio=4.65; 95% CI, 1.406-15.381; p=0.012).


Patients with high pelvic tilt had a higher grade of lumbar disc degeneration in the L4-L5 segment regardless of age or gender.


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Fig. 1.
Radiography of a 67-year-old male with high pelvic tilt. (A) Upright lateral X-ray. (B) T2 sagittal image of lumbar magnetic resonance imaging.
Fig. 2.
Radiography of a 69-year-old male with low pelvic tilt. (A) Upright lateral X-ray. (B) T2 sagittal image of lumbar magnetic resonance imaging.
Table 1.
Descriptive data of patients
Age (yr) 60.87(±6.55)
Weight (kg) 61.60(±9.71)
Height (cm) 160.80(±6.88)
Body mass index (kg/m2) 23.73(±2.77)
Lumbar lordosis 26.65(±7.22)
Pelvic tilt 14.67(±11.41)
Sacral slope 36.77(±9.35)
Pelvic incidence 49.65(±12.57)
Sagittal vertical axis (mm) 10.59(±18.57)
Male/Female 30/30

Values are presented as mean ± standard deviation.

Table 2.
Comparison between Low PT group and High PT group
  Low PT group (31) High PT group (29) p-value
Age(yr) 59.77(±6.96) 62.03(±5.98) 0.184
Weight(kg) 61.71(±10.35) 61.48(±9.16) 0.929
Height(cm) 161.19(±6.62) 160.38(±7.24) 0.651
Body mass index (kg/m2) 23.64(±2.93) 23.83(±2.93) 0.792
Lumbar lordosis 45.94(±12.27) 39.17(±10.25) 0.025
Pelvic tilt 5.55(±5.12) 24.41(±7.46) <0.001
Sacral slope 39.58(±9.68) 33.76(±8.09) 0.015
Pelvic incidence 43.13(±10.52) 56.62(±10.82) <0.001
Sagittal vertical axis(mm) 11.76(±18.76) 9.42(±17.62) 0.256
Male:Female 15:16 15:14 0.796
Table 3.
Comparison of radiologic parameter on MRI between low PT group and high PT group using t-test
  Low PT group (31) High PT group (29) p-value
L1-2 2.61(±0.92) 2.34(±0.55) 0.174
L2-3 2.61(±0.72) 2.62(±0.73) 0.967
L3-4 3.00(±0.63) 3.07(±0.59) 0.665
L4-5 3.39(±0.67) 3.76(±0.64) 0.031
L5-S1 3.84(±0.82) 3.55(±0.99) 0.224
Table 4.
Comparison of radiologic parameter between low PT group and high PT group using chi-square test
  Low PT group(31) High PT group(29) p-value
L1-2 (high grade) 24(77.4%):7(22.6%) 28(96.6%):1(3.4%) 0.053
L2-3 (high grade) 27(87.1):4(12.9%) 25(86.2%):4(13.8%) 1.000
L3-4 (high grade) 25(80.6%):6(19.4%) 23(79.3%):6(20.7%) 0.897
L4-5 (high grade) 16(51.6%):15(48.4%) 6(20.7%):23(79.3%) 0.013
L5-S1 (high grade) 9(29.0%):22(71.0%) 9(31.0%):20(69.0%) 0.866
Table 5.
Odd ratio of high grade degeneration of L4-5 on MRI by logistic regression analysis
  Odd ratio p-value 95% CI
High pelvic tilt 4.650 0.012 1.406∼15.381
Gender 1.845 0.307 0.569∼5.979
Age 0.973 0.554 0.890∼1.065
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