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Scientific Papers - The Way You Sit Will Never Be the Same! Alterations of Lumbosacral Curvature and Intervertebral Disc Morphology in Normal Subjects in Variable Sitting Positions Using Whole-body Positional MRI

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PARTICIPANTS
Presenter
Waseem Bashir MBChB  
Abstract Co-Author
Tetsuya Torio MD  
Francis Smith MD  
Keisuke Takahashi  
Malcolm Pope PhD  
  CODE: SSC20-07
  SESSION: Musculoskeletal (Intervertebral Disks: Diagnosis and Intervention)
  The Way You Sit Will Never Be the Same! Alterations of Lumbosacral Curvature and Intervertebral Disc Morphology in Normal Subjects in Variable Sitting Positions Using Whole-body Positional MRI
 
 
  DATE: Monday, November 27 2006
  START TIME: 11:30 AM
  END TIME: 11:40 AM
  LOCATION: S406B



  DISCLOSURES
  W.B. - Nothing to disclose.  
  T.T. - Nothing to disclose.  
  F.S. - Nothing to disclose.  
  K.T. - Nothing to disclose.  
  M.P. - Nothing to disclose.  

 PURPOSE
 
To define the optimal sitting posture by investigating variable seated positions using positional MRI. Normal lumbar spine position during sitting has long been debated. In 1953, Keegan hypothesised a relationship between lordosis and trunk-thigh angle using plain radiography of only 4 individuals. No one has ever replicated his original study.
  
 METHOD AND MATERIALS
 
Measurements of lumbar lordosis angles, intervertebral disc (IVD) heights and translation of the nucleus pulposus (NP) were made on 22 normal subjects with no history of back pain or surgery using a 0.6 Tesla whole-body positional MRI scanner. We then determined which sitting position showed the least biomechanical stress on the lumbar spine. This study would not have been possible on a regular fixed ‘tunnel’ recumbent scanner.
  
 RESULTS
 
We found IVD height showed a tendency to decrease as lumbar lordosis decreased in variable sitting positions from reclining to forward flexion. The NP showed movement within a limited range in normal IVDs without change of its overall area. The optimal sitting position was with a trunk-thigh angle of 135 degrees. This position was shown to cause least 'strain' on the lumbar spine, most significantly when compared with an upright 90 degree sitting posture.
  
 CONCLUSION
 
We have adapted a small plain radiography study from 53 years ago and shown the best biomechanically and anatomically 'neutral' sitting postion using positional MRI. It is well known that a relationship exists between seating posture and back pain and therefore this study has provided data that will help to reduce the incidence of chronic back problems from bad sitting positions.
  
 CLINICAL RELEVANCE/APPLICATION
 
We have shown that positional MRI is of value in the evaluation of future seating design and as a result help to reduce chronic back problems from bad seating posture.
  
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