Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 1

The Association of Presacral Nodules with Biomechanics of the Lumbar Region and Lumbar Discopaties in Patients with Low Back Pai

Öznur Öken 1 ,Mine Köybaşı 2 ,Işıl Tunçbilek 3 ,Figen Ayhan 2 ,Rezan Yorgancıoğlu 2
1 Clinic of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
2 Ankara Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
3 Ankara Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, Ankara, Türkiye

Objective: The aim of this study was to investigate the relationship between Copeman’s nodules, which are seen in the presacral region, and demographic features such as: age, gender, body mass index, number of pregnancies, and presence of lumbar disc lesions and biomechanics of the lumbar region.

Materials and Methods: This trial included 58 inpatients (49 women, 9 men; mean age SD:40.7±11.7 years, range 21-67 years) with low back pain. Standing lateral roentgenograms of lumbo-sacral region, ultrasonography of soft tissues and lumbar magnetic resonance imaging were performed in all patients. Sacral angle, lumbo-sacral angle and lumbar lordotic curve were evaluated using Cobb’s method in lumbo-sacral x-rays.  

Results: Significant correlations between Copeman’s nodules and body mass index, presence of lumbar discopathy, degrees of lumbar lordotic curve were found. However, age, gender, number of pregnancies, sacral and lumbosacral angle did not correlate with the presence of Copeman’s nodules. 

Conclusion: Copeman’s nodules may represent the alterations of the biomechanics of lumbo-sacral region and lumbar disc herniation due to weakness of abdominal muscles. Therefore, strengthening of abdominal muscles and correction of lumbar biomechanics in patients with nodules and low back pain are important in the management of lumbar lordosis.

Keywords : Copeman’s nodules, low back pain, lumbar disc herniation, lumbar lordotic curve