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Roentgenographic analysis of lumbar lordotic dimensions among indigenes ofDelta State
Article · May 2020
DOI: 10.4314/aja.v9i1.13

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https://dx.doi.org/10.4314/aja.v9i1.13
Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.

ROENTGENOGRAPHIC ANALYSIS OF LUMBAR LORDOTICDIMENSIONS AMONG INDIGENES OF DELTA STATE
Ugochukwuka Ojieh, Abimbola Oladunni Ebeye**Department of Human Anatomy, Delta State University, Abraka, Nigeria.
Correspondence to Ugochukwuka Ojieh, Synergy Lifeline Consulting, Second Floor, Nicon Insurance
Plaza, Plot 242, Muhammadu Buhari Way, Central Business District, Abuja. Email:ugoojieh@gmail.com, Phone: 08036988076.
ABSTRACTThe spinal column of humans possesses strategically placed concave and convex curves which workin harmony to give an upright posture. The inwardly concave curvature in the lumbar region of thespine is known as the lordosis and it plays a very important role in the formation of the posture ofhumans. Analysis of the human lordosis is of great importance as it has been shown to be a major
factor in the onset of low back pain, and is of great importance in spinal reconstructive surgery,through which some form of repair can be done to the spinal column that has undergone some formof alteration. The present study was carried out to analyse the lumbar lordotic dimensions amongindigenes of Delta State. The aim of the study was to find out the average lordotic angle, vertebral
body height and intervertebral disc height for the male and female population. The study was also
aimed at finding the range for the normal lordotic angles as well as the correlations between these
dimensions and the age of an individual. A regression equation was also formulated with which thelordotic angle of an individual can be estimated given the age of that individual. The sample size was
384 individuals (204 males and 180 females) with an age range of 20-60 years. The male population
had a mean angle of 59.33±2.45° and the females had a lower mean value of 53.33±2.61°. The
study showed males had higher mean values for lumbar vertebra height and intervertebral disc height.
A steady increase in the height of the lumbar vertebra and intervertebral disc from the first to thelast was observed in this study. This study also showed that a weak negative correlation existed
between the age of an individual and the lordotic angle and the vertebral height. Correlations between
the age and intervertebral disc height showed a weak positive correlation. A regression formula wasderived for estimating the lordotic angle of an individual given the age. This study will be of great
importance to medical practitioners and forensic anthropologists in spinal reconstructive surgery andforensic human identification by gender and age.
Keywords: Lumbar Spine. Lordosis, Lordotic Angle, Correlation, Regression.
INTRODUCTION
Proper physique is important for optimalfunctionality of the human body. One of the
major determining factors of the physique ofan upright human is the structure of the spinal
column (Farahani et al., 2012, Ambegaonkar etal., 2014, Been et al., 2014, Been et al., 2017).
The upright posture of humans is constantly
maintained by the spinal and pelvic muscles,
hence weakness in this muscles, lack of proper
exercise and inappropriate push or pull
movements using these muscles will ultimately
lead to body imbalances which culminate in
improper posture (Kendall, 1983, Castillo &Lieberman, 2015).This upright posture in
humans is as a result of the presence ofcharacteristic concave and convex curves on
the spinal column. The concave curves, known
as Lordotic curves and are found in the cervicaland lumbar regions of the spine while theconvex curves, called Kyphotic curves and arefound in the thoracic and sacral spinal regions.
The presence of these curves in the spinal
column of an upright man is necessary in themaintenance of the upright posture as it gives
a great degree of stability to the head and torso
over the lower limbs and allows for proper

Submitted 8th October 2018. Published online 1st February 2020. To cite: Ojieh U, Ebeye AO. Roentgenographic
analysis of lumbar lordotic dimensions among indigenes of Delta State. Anatomy Journal of Africa. 2020, 9 (1): 1736
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Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.
absorption of loads applied on the spinal
column (Gracovetsky & Iacono, 1987; Farfan,
1995; Gomez-Olivencia et al., 2013; Arsuaga etal., 2015). They also present him with theadvantages of greater sight, increased speed
and an increased gamut (Bushe-McGregor etal., 1981). Man can thus easily balance himself
on two feet and use his upper limbs forfunctions other than locomotion.

the last lumbar segment (L5) contributes
almost 40% to overall lordosis while the first
segment (L1) contributes only 5% (Been et al.,2010).
Lumbar lordotic angle values for humans asreported by Been et al, (2013) ranges from 30º
to 80º. Values lower than this result in lumbar
hypolordosis and values greater result in
lumbar hyperlordosis. In the African and
Nigerian perspective, studies on lumbar
lordotic angles are evidently deficient andhence the knowledge of lumbar lordosis among
African populations including Nigerians issparse and those available, to the best of ourknowledge have conflicting results (Patrick,
1976, Murrie et al., 2003, Legaye, 2007,
Oyakhire et al., 2013).The general objective of
this study was to study the lumbar lordotic
dimensions among indigenes of Delta State.

One of the major postural analysis of anindividual is that of his lumbar lordosis. Lumbar
lordosis. Lumbar lordosis is defined to be theinwardly concave curvature which extends
from the first lumbar vertebrae to the fifth
lumbar vertebrae, formed majorly by thewedging of the intervetebral discs of each ofthese vertebrae and counters the forward
inclination of the sacrum and thus restores the
upward inclination of the spinal column. Of thefive lumbar vertebrae which forms the lordosis,

MATERIALS AND METHODThis study was a descriptive cross-sectional
study and was retrospective in nature andradiographs which were used for this study
were obtained from the archives of a selected
tertiary health institution. The reasons for the
retrospective nature of this study were among
others to avoid the ethical issues of
unnecessary exposure of individuals toradiation as some individuals, after radiologic
evaluation would have presented pathologicalabnormalities and would be ultimately
excluded from the study.

vertebra and the intervertebral discs between
L1 and L5 respectively where used.
Radiographs taken with an Allengers Ceiling
Suspended Static X-Ray Unit were displayed on
a computer monitor screen so as to better
highlight the landmarks from which themeasurements were taken. Measurements
were taken using the Clear Canvas (Version3.0) software. The Cobb’s method was used tomeasure the lumbar lordotic angle on theradiographs. The vertebral body height and theintervertebral disc height were measured using
special digital vernier calipers on the Clear
Canvas (Version 3.0) software.

The heterogeneous population was stratified
according to ethnic group into homogenous
subsets of Delta State Indigenes. Elements
were then randomly selected from each of thesubsets in a manner which insured equal
representation of each homogeneous subset.

Data collected from the study was subjected tostatistical analysis using the IBM Corp, IBM
SPSS Statistics for Windows, Version 22.0.
Armonk, NY:IBM Corp. Results were analysed
for Descriptive Statistics, Independent Sample
T-test, Pearson Correlation and Regression
equation.

For this study, 384 digital lateral lumbar
radiographs of individuals between the ages of
18-60 years, were free of any congenitalabnormalities and clearly showed that 5 lumbar

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Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.

Figure 2. Measurement of Vertebral bodyheightFigure 1. Measurement of Lumbar
Lordotic angle

Figure 3. Measurement of Intervertebral
disc height

RESULTS
Results from the study showed that males hada mean lumbar lordotic angle of 59.35°±2.45
and females and mean lumbar lordotic angle of
53.33°±2.61. Males thus showed higher meanvalues than females and this difference wasshown to be statistically significant (p=0.001).
For the five lumbar vertebra, males had steadyhigher mean values than females. In every
case

the difference between male and female values
was shown to be statistically significant(p≤0.05); (Table X). For both males andfemales, a steady increase was observed in themean values of of the five lumber vertebrae
from L1 to L5 (Figure X).

Table 1. Values for Male and Female Lumbar Lordotic Angles
N = 384
VALUE
MALE = 204
59.35°±2.45
FEMALE = 180

53.33°±2.61

P – Value

0.001

Table 2. Mean values for the five lumbar vertebrae in males and females
L1

L2

L3

L4

L5

MALE

2.89±0.32

3.05±0.29

3.14±0.28

3.25±0.26

3.42±0.26

FEMALE

2.67±0.30

2.84±0.28

2.96±0.28

3.09±0.28

3.26±0.25

P - Value

0.001

0.001

0.001

0.001

0.001

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Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.

Figure 4. Graph showing the steady increase in mean values of the five lumbar vertebrae in males
and females.
The four lumbar intervertebral discs also
showed steady higher mean values in males
than in females and these differences where allshown to be statistically significant (p≤0.05);(Table X). Among males and females, it wasobserved that the height of the intervertebral
discs increased steadily from the first to thefourth intervertebral disc.

IVD1

IVD2

IVD3

IVD4

MALE

1.03±0.23

1.23±0.25

1.39±0.24

1.56±0.26

FEMALE

0.97±0.22

1.17±0.19

1.32±0.18

1.49±0.22

P – Value

0.033

0.001

0.002

0.005

Table 3. Mean Values for the four intervertebral discs in males and females.

Figure 5: Graph showing the steady increase in intervertebral disc heights from the first to the fourth in males and females.

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Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.
Pearson Correlation tests showed that age had a weak negative correlation with lumbar lordotic angles
and with vertebral body heights. This means that an increase in the age of an individual would leadto a decrease in the lumbar lordotic angle and lumbar vertebral body height. Conversely, thecorrelations between age and the lumbar intervertebral disc height were shown to be weak positive
correlations. This means that an increase in the age of an individual would result in a corresponding
increase in the lumbar intervertebral disc height. (Table X).
PearsonCoefficient

Correlation Sig.

Age * LLA

-0.1490.005

Age * L1

-0.7700.149

Age * L2

-0.1400.009

Age * L3

-0.1550.004

Age * L4

-0.1790.001

Age * L5

-0.1380.010

Age * IVD1

0.161

0.003

Age * IVD2

0.190

0.001

Age * IVD3

0.121

0.025

Age * IVD4

0.088

0.101

Table 4. Correlations between age and various parameters
FemaleMale

Coefficient

Std. Error

Coefficient

Std. Error

Constant (K)56.857.880

59.290

.889

B

-.078

.019

.002

.020

Table 5. Regression table
The regression equation formula is given as X = k + bY. Where; X = dependent variable. k = Constant; b = ……; Y =independent variable; From the table 4.25 above; k = 56.857(females); 59.290 (males); b = -0.078(females); 0.002 (males).
Putting the figures above in the formula, the regression equation for LLA given the age of an individual is; Female X =56.857 – 0.078Y. Male X = 59.290 + 0.002Y.

DISCUSSION
The study measured the lumbar lordotic anglesof the males and females study population. The
male participants had a minimum angle of58.70° and a maximum value of 65.80°, with amean angle of 59.35±2.45°. Female
participants had lower values with a minimum
value of 39.40° and a maximum value of

58.90°, with a mean angle of 53.33±2.61°.The
results of this study varied from those ofstudies by Oyakhire et al., (2013) amongindigenes of Port-Harcourt; Ayad et al., (2013)
among
Sudanese;
Okpala(2014)
inSoutheastern Nigerians; Abdelmonem et al.,(2014) in Egyptians, all of which showed
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Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.
greater lordotic angles values in Females
compared to males. Several factors such as
method of measurements and ethnicity could
have been contributing factors to thesevariations.

considered to be significant at a level ofP≤0.05.
The difference between the mean Lumbar
Lordotic angle for males and females wasshown to be statistically significant (P=0.001).
These results differed slightly from those of
Oyakhire et al., (2013), Ayad et al, 2013,
Okpala 2014 etc, who though found a
statistically significant difference in lumbar
lordotic angles of both genders, recorded
females as having higher mean values forlumbar lordotic angles, compared to men.

The height of the five lumbar vertebrae whichforms the lumbar lordosis was also measured
in the course of this study (Tables 4.3- 4.7 andFigs. 4.3- 4.7). Among the male population themean heights of the vertebrae were 2.89±0.32
for L1, 3.05±0.29 for L2, 3.14±0.28 for L3,
3.25±0.26 for L4 and 3.42±0.26 for L5. The
female population showed lower mean values
for heights of the 5 lumbar vertebrae vis.
2.67±0.30 for L1, 2.84±0.28 for L2, 2.96±0.28
for L3, 3.09±0.28 for L4 and 3.26±0.25 for L5.

For the five different lumbar vertebrae (L1-L5)
males had larger mean values in all occasions
and the mean difference between males andfemales, when tested, where all statisticallysignificant (L1=0.001; L2=0.001; L3=0.001;
L4=0.001; L5=0.001). Males also had agreater mean intervertebral disc height,
compared to the females and the difference
and the difference between the between themean intervertebral disc height between males
and females was statistically significant for all
four lumbar intervertebral discs with P valuesof 0.03, 0.0, 0.01 and 0.05 for the first to fourth
lumbar intervertebral respectively.

Among the male and female population asteady increase in the heights of the vertebrae
was observed from L1-L5 with L5 being thelargest of all (Fig. 4.8).These observationagreed with those of Busche-McGregor et al.,(1981) who observed that the fifth lumbar
vertebra was the largest and contributed mostto the lumbar lordosis. A theory also acceptedby Been and Kalichman, 2017.
The heights of the intervertebral discs locatedwithin the lumbar region of the spinal column
were measured among the males and femaleswith the males showing larger values for theheights compared to females (Tables 4.8 –4.11 and Figs. 4-9-4.12).

Pearson’s correlation test carried out to find out
the correlation existing between age andlumbar lordotic angle among the sample
population showed that a weak negative
correlation existed between both variables (0.149). This correlation was statisticallysignificant (P=0.005). This agreed with thestudy of Murrie et al., 2003 who stated thatwith increasing age there is a decrease of thelumbar lordotic angle. It however did not agreewith the studies of Youdas et al., 1996 andKalichman et al., 2011 who did not find any
correlation between age and lumbar lordotic
angle.

Among the male population, the heights of theintervertebral
discs
were
1.03±0.23,
1.23±0.25, 1.39±0.24 and 1.56±0.26 for the
first, second, third and fourth intervertebral
discs respectively. Among the female
population, the heights of the intervertebral
discs were 0.97±0.22, 1.17±0.19, 1.32±0.18
and 1.49±0.22 for the first, second, third andfourth intervertebral discs respectively.
The values for the heights of the lumbar
vertebra and their corresponding intervertebral
discs showed that males had a longer lumbar
lordosis than females, a theory that agreed
with the study of Hay et al., (2015).

Results from this study also showed a negative
correlation between age and the height of eachof the five lumbar vertebra. This means that anincrease in the age of an individual will
ultimately lead to a decrease in the height of
the lumbar vertebra.

Independent samples T-test was used to test
for significance of gender differences among all
the variables. The mean difference wasResults however showed weak positive
correlations between age and the height of the1741

Anatomy Journal of Africa. 2020. Vol 9 (1): 1736 - 1743.
intervertebral disc among the individuals and in
the case of the fourth lumbar intervertebral
disc this correlation was statistically notsignificant. It may be hypothesized that thepositive correlation noticed which means anincrease in age will lead to an increase inintervertebral disc height is not unrelated to
the negative correlation observed between age
and vertebral height as a decrease in thevertebral height may be complimented by anincrease in the corresponding intervertebral
disc. This theory though, remains to beclarified.

women. This may also explain the higher
incidence of low back pain in men than womenas reported by Oyakhire et al., 2013 as the men
are closer to having a flat back than thewomen. Unconfirmed reports in a study by
Stagnara et al., 1982 have also reported thatthe steeper curve in women is as a result of thelarger buttock size and more prominent
backward curve in women compared to men.
This occurrence brings about the need for acompensating forward lean of the lumbar
region. Moore et al., 2014 also stated that the
number of pregnancies a woman may have had
could have an effect on her lumbar lordosis andhe further stated that the new lordosis usuallyremains after pregnancy. This could also be
hypothesized as a reason for the steeper
lordosis among the females.

A regression equation with which the lumbar
lordotic angle of an individual can be calculated
given the age of the individual was also
developed. Where Female X = 56.857 – 0.078Y
and Male X = 59.290 + 0.002Y, where X stands
for the lumbar lordotic angle of the individual
and Y stands for the age of the individual.

Results from this study showed that amongindigenes of Delta State, normal lordosis
ranges from 30°-70°, a slight variation fromthe generally accepted range of 30°-80°. Thisvariation could be related to factors such as
stature, occupation, and ethnicity.

In conclusion indigenes of Delta State, males
have a significantly longer lordosis and a higher
lumbar lordotic angle than the females. This
shorter and steeper curve noticed among thefemales could be attributed to various tasks
which they undergo such as carrying of heavyloads on their heads, carrying of children on
their backs and others which make for a much
deeper curve in the lumbar spine of the

It is recommended that this kind of research be
carried out on more independent ethnic groups
and if possible, using a prospective approachas this would give even more concise results.

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