The inclusion criteria were (1) chief complaint being LBP on standing or walking, (2) sagittal vertical axis (SVA) [11] > 60 mm on a standing radiograph, (3) more than some mobility of the anterior element and (4) inter spinous distance < 2 mm at three levels or more on mid-sagittal computed tomography image. The typical posture of the patients is shown in Figure 1. The exclusion criteria were as follows: (1) age < sixty years, (2) history of fusion operation, (3) scoliosis with lumbar curvature at a Cobb angle > 15°, (4) lumbar spinal stenosis on magnetic resonance imaging, (5) lumbar zygapophysial arthrosis [12], (6) sacro-iliac arthrosis [13] and (7) spondylolisthesis Meyerding grade ≥ II. These criteria were diagnosed radiologically or by physical findings or relevant block procedures if needed. The demographic data of the study population is shown in Table 1.

Typical gait of this group of patients. These patients often use walking aids.

Demographics.

F: female, M: male, BMI: body mass index.

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