Poster Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Introduction: Low back pain (LBP) is a highly prevalent pathology, afflicting over 600 million people globally.¹ Lumbosacral radiculopathy is a common cause of LBP; in this condition, nerve roots in the lumbosacral spine are compressed, contributing to weakness, pain, and muscle atrophy². As a result, lumbosacral unilateral radiculopathy (UR) can lead to altered gait mechanics, functional limitations (e.g. lifting activities), and lower limb hyporeflexia^3,4. However, there has been limited exploration into the impact of this pathology on performance of physical activities and joint range of motion (RoM). The aim of this study was to evaluate lifting technique and disability in patients with unilateral lumbosacral radiculopathy and compare it with healthy controls.

Method: Patients were fitted with a full-body external reflective marker set for a three-dimensional analysis of the lifting performance of the lower extremities and trunk. Each patient completed nine lifting tasks where a box weighing no more than 10% of body weight was lifted onto a one-meter-high table: three trials were completed with the box to the right, three with the box to the left, and three with the box placed centrally. Linear mixed-effects regression models were estimated with a random intercept at the subject level and only the group as a categorical independent variable.

Results: Thirty-eight patients with UR and 34 healthy controls were included in this study. For range of motion, patients with UR completing the asymmetrical lift presented with reduced lumbar spine rotation (65.4° vs 71.8°, p = 0.003) and pelvic rotation (44.6° vs. 49.6°, p = 0.027), as well as reduced hip flexion bilaterally (left: 76.4° vs. 87.2°, p = 0.004; right: 77.5° vs. 88.6°, p = 0.002) relative to controls. Additionally, patients with UR completing this activity also presented with greater right knee adduction (31.3° vs. 23.7°, p = 0.004), as well as hip rotation (29.0° vs. 20.9°, p = 0.019) relative to controls. Lastly, when completing the symmetrical lift exercise, patients with UR presented with reduced hip flexion bilaterally (left: 64.87° vs. 72.75°, p = 0.010; right: 63.86° vs. 72.24°, p = 0.008), in addition to greater left knee adduction (29.52° vs. 21.58°, p = 0.037) relative to controls. When completing the asymmetrical lift exercise, patients with UR presented with reduced hip flexion angle bilaterally (left: 89.7°, right: 90.3° vs. 97.9°, p < 0.004) relative to healthy controls at the begging of the lift. Lastly, when completing the symmetrical lifting exercise, patients with UR likewise presented with reduced hip flexion on both the left and right (left: 90.11°, right: 89.76° vs. 96.93°, p < 0.005).

Conclusions: This study demonstrates patients with UR had significantly altered lifting patterns. These biomechanical alterations may be risk factors for worsening UR symptoms and performance in patients completing asymmetric and symmetric lifting activities. The results of this study are useful to spine care providers and ergonomists when designing neuromuscular control training programs, both for injury avoidance and injury rehabilitation protocols.