A cross-sectional study correlating lumbar spine degeneration with disability and pain.
METHODS
Cross-sectional design.


OBJECTIVE
To investigate the correlation between degeneration in the lumbar spine and self-reported disability and pain levels in patients with and without a history of trauma.


BACKGROUND
The link between lumbar spine degeneration and low back pain remains controversial, as does the correlation between trauma and spinal degeneration.


METHODS
Radiographic and questionnaire data were collected from 172 consecutive patients with low back pain. Back pain severity was measured using two scales: one for pain over the entire episode and one for pain during the previous week. All patients also completed the Revised Oswestry Disability Questionnaire before radiography was performed. Further questions concerning the chronicity of symptoms and trauma were included.


RESULTS
Controlling for age, patients with low back pain with a history of trauma had a statistically significant increase in the severity of facet degeneration (P < 0.02) compared with nontrauma patients with low back pain. However, there was no difference in disability and pain scores between the trauma and nontrauma patients or between the genders. A weak correlation between pain severity ratings and the number of levels of degeneration and the severity of the degeneration at the disc and facets was noted.


CONCLUSIONS
Patients with low back pain with a history of trauma had more severe facet arthrosis than do nontrauma patients with low back pain, but there were no differences in pain and disability. There was a weak correlation between the quantity and severity of lumbar degeneration with pain levels, but not with disability scores. These findings are discussed in the light of recent reports regarding the cervical spine.
Peterson
C K
CK
Department of Academic Affairs, Anglo-European College of Chiropractic, Bournemouth, United Kingdom. cpeterson@aecc-chiropractic.ac.uk
Bolton
J E
JE
Wood
A R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019567:Back Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016014:Linear Models; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000523:psychology / Q000706:statistics & numerical data*; D011859:Radiography; D018709:Statistics, Nonparametric