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Spinal Posture and Pathology in Modern Humans

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Spinal Evolution

Abstract

Humans are the only living hominoid that habitually stands upright and walks on two legs. The adoption of erect posture as habitual imposed substantial changes on spinal morphology and biomechanics. One of the major morphological changes is the increased curvatures found in the human spine. There is an ongoing debate about whether humans “pay” for becoming bipedal by suffering from a high prevalence of back pain and spinal pathology. In order to answer this question, we explored the relationship between sagittal spinal posture and spinal pathologies, back pain, and health-related quality of life. We found that spinal posture closely correlates with spinal pathology. Individuals with a well-aligned spine—within the neutral zone defined as moderate spinal curvatures and the line of gravity close to the acetabulum—have a better quality of life, less back pain, and less spinal pathology. Individuals out of the neutral zone, with accentuated or with decreased pelvic incidence and spinal curvatures, are at a higher risk for developing spinal pathology, back pain, and reduced quality of life. All of this indicates that adopting an erect posture and bipedalism has an impact on human’s spinal health because variation in curvatures outside the neutral zone is associated with more spinal pathology, back pain, and lower quality of life, than those within this zone.

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Authors and Affiliations

  1. Department of Sports Therapy, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel

    Ella Been

  2. Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Ella Been

  3. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Azaria Simonovich

  4. Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Leonid Kalichman

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  1. Ella Been
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  2. Azaria Simonovich
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  3. Leonid Kalichman
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Editors and Affiliations

  1. Department of Sports Therapy, Department of Anatomy and Anthropology, Faculty of Health Professions, Ono Academic College, Sackler Faculty of Medicine, Kiryat Ono, Tel Aviv, Israel

    Ella Been

  2. Departmento de Estratigrafía y Paleontología, Facultad de Ciencia y Tecnología, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), IKERBASQUE, Basque Foundation for Science, Bilbao, Spain, Centro Mixto UCM-ISCIII de Evolución y, Comportamiento Humanos Avda. Monforte de Lemos, Leioa, Madrid, Spain

    Asier Gómez-Olivencia

  3. Departments of Anthropology and Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA

    Patricia Ann Kramer

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Been, E., Simonovich, A., Kalichman, L. (2019). Spinal Posture and Pathology in Modern Humans. In: Been, E., Gómez-Olivencia, A., Ann Kramer, P. (eds) Spinal Evolution. Springer, Cham. https://doi.org/10.1007/978-3-030-19349-2_13

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