Parity, menopausal timing, and spinopelvic mismatch: a moderated mediation analysis of low back pain in postmenopausal women
European Spine Journal, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00586-026-10408-2
- Dergi Adı: European Spine Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Low back pain, Menopause, Parity, PI–LL mismatch, Spinopelvic alignment
- Gazi Üniversitesi Adresli: Evet
Özet
Purpose: To evaluate the association of parity and menopausal timing with spinopelvic alignment in postmenopausal women and whether pelvic incidence–lumbar lordosis (PI–LL) difference statistically mediates the association between parity and low back pain. Methods: This single-centre cross-sectional study included 239 postmenopausal women aged ≥ 45 years. Standardised standing lumbosacral radiographs were used to measure pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, and PI–LL difference. PI–LL mismatch was defined as ≥ 10°. Pain severity was assessed using a visual analogue scale. Multivariable regression and mediation analyses were performed. Results: Higher parity was associated with greater pelvic incidence, sacral slope, and PI–LL difference. Pelvic incidence differed significantly across parity groups (nulliparous, 1–2 deliveries, and ≥ 3 deliveries) (H(2) = 30.163, p < 0.001), with median values of 43.80° (40.30–47.50) in nulliparous women and 48.35° (44.80–51.30) in women with ≥ 3 deliveries. Earlier menopausal age was associated with greater PI–LL difference. PI–LL mismatch was present in 25.5% of women and was associated with higher pain severity (p < 0.001). Conclusion: Higher parity and earlier menopausal age were associated with differences in measured spinopelvic parameters, particularly PI–LL difference. Reproductive history and menopausal timing may be clinically relevant when interpreting low back pain in postmenopausal women. Level of Evidence: IV.