Clinical significance of congenital lumbosacral malformations in young male population with prolonged low back pain.
METHODS
A prospective clinical investigation.


OBJECTIVE
To determine the clinical significance of congenital lumbosacral malformations in young male patients with subacute or chronic low back pain and to investigate a possible worsening of the clinical picture with the concurrence of transitional vertebra (TV) or spina bifida occulta (SBO).


BACKGROUND
Although the causative roles of congenital malformations in low back pain and lumbar disc herniation have been investigated, there is no study that compares the incidence of congenital malformations in prolonged low back pain between radicular and nonradicular groups; nor is there a study that compares the pain intensity between the groups with and without congenital malformations.


METHODS
Lumbosacral plain radiographs of 881 young male patients with low back pain lasting for >4 weeks were evaluated. For all patients, we recorded the clinical signs and their pain intensities based on a 10-cm visual analog scale (VAS).


RESULTS
Congenital lumbosacral malformations were determined in 88 of 881 patients. Of these, 48 were TV, 38 were SBO, and 2 were a combined lesion of TV and SBO. The difference in positive clinical sign and VAS was statistically significant (P < 0.05) between the groups with and without congenital lumbosacral malformations. In contrast to SBO, there was a statistically significant difference of TV incidence between the sign positive and the sign negative groups (P < 0.05). The difference in VAS values was statistically significant for both TV and SBO (P < 0.001).


CONCLUSIONS
The results of this study show that SBO and TV increase the severity of the clinical picture whether or not they have a causal relationship. Additionally, transitional vertebrae seem to increase nerve-root symptoms whereas spina bifida occulta does not.
Taskaynatan
Mehmet Ali
MA
Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. matask@gata.edu.tr
Izci
Yusuf
Y
Ozgul
Ahmet
A
Hazneci
Bulent
B
Dursun
Hasan
H
Kalyon
Tunc Alp
TA
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000002:abnormalities*; D008297:Male; D010147:Pain Measurement; D011859:Radiography; D012447:Sacrum / Q000002:abnormalities*; D012720:Severity of Illness Index; D016136:Spina Bifida Occulta / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology