Special Communication  |   September 2019
Modern Medical Consequences of the Ancient Evolution of a Long, Flexible Lumbar Spine
Author Notes
  • From the Department of Biomedical Sciences (Dr Selby) and the Department of Osteopathic Manipulative Medicine (Dr Sampson) at the Georgia Campus-Philadelphia College of Osteopathic Medicine in Suwanee (Student Doctors Gillette, Raval, and Taufiq) and the Philadelphia College of Osteopathic Medicine South Georgia in Moultrie (Dr Sampson). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Michael S. Selby, PhD, Department of Biomedical Sciences, Georgia Campus-Philadelphia College of Osteopathic Medicine, 625 Old Peachtree Rd NW, Suwanee, GA 30024-2937. Email: michaelsel@pcom.edu
     
Article Information
Neuromusculoskeletal Disorders
Special Communication   |   September 2019
Modern Medical Consequences of the Ancient Evolution of a Long, Flexible Lumbar Spine
The Journal of the American Osteopathic Association, September 2019, Vol. 119, 622-630. doi:10.7556/jaoa.2019.105
The Journal of the American Osteopathic Association, September 2019, Vol. 119, 622-630. doi:10.7556/jaoa.2019.105
Web of Science® Times Cited: 1
Abstract

Modern human bipedality is unique and requires lumbar lordosis, whereas chimpanzees, our closest relatives, have short lumbar spines rendering them incapable of lordosis. To facilitate lordosis, humans have longer lumbar spines, greater lumbosacral angle, dorsally wedged lumbar vertebral bodies, and lumbar zygapophyseal joints with both increasingly coronal orientation and further caudal interfacet distances. These features limit modern lower lumbar spine and lumbosacral joint ailments, albeit imperfectly. The more coronal zygapophyseal orientation limits spondylolisthesis, while increasing interfacet distance may limit spondylolysis. Common back pain, particularly in people who are obese or pregnant, may result from increased lumbar lordosis, causing additional mass transfer through the zygapophyseal joints rather than vertebral bodies. Reduction in lumbar lordosis, such as in flatback syndrome from decreased lumbosacral angle, can also cause back pain. Human lumbar lordosis is necessary for placing the trunk atop the pelvis and presents a balancing act not required of our closest primate relatives.

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