Prevalence of radiographic lumbar spondylosis and its association with low back pain in elderly subjects of population-based cohorts: the ROAD study.
OBJECTIVE
Although lumbar spondylosis is a major cause of low back pain and disability in elderly people, few epidemiological studies have been performed. The prevalence of radiographic lumbar spondylosis was investigated in a large-scale population study and the association with low back pain was examined.


METHODS
From a nationwide cohort study (Research on Osteoarthritis Against Disability; ROAD), 2288 participants aged > or =60 years (818 men and 1470 women) living in urban, mountainous and coastal communities were analysed. The radiographic severity at lumbar intervertebral levels from L1/2 to L5/S was determined by Kellgren/Lawrence (KL) grading.


RESULTS
In the overall population the prevalence of radiographic spondylosis with KL> or =2 and > or =3 at the severest intervertebral level was 75.8% and 50.4%, respectively, and that of low back pain was 28.8%. Although KL> or =2 spondylosis was more prevalent in men, KL> or =3 spondylosis and low back pain were more prevalent in women. Age and body mass index were risk factors for both KL > or =2 and KL> or =3 spondylosis. Although KL = 2 spondylosis was not significantly associated with low back pain compared with KL = 0 or 1, KL> or =3 spondylosis was related to the pain only in women.


CONCLUSIONS
This cross-sectional study in a large population revealed a high prevalence of radiographic lumbar spondylosis in elderly subjects. Gender seems to be distinctly associated with KL> or =2 and KL> or =3 lumbar spondylosis, and disc space narrowing with or without osteophytosis in women may be a risk factor for low back pain.
Muraki
S
S
22nd Century Medical & Research Center, University of Tokyo, Tokyo 113-8655, Japan.
Oka
H
H
Akune
T
T
Mabuchi
A
A
En-Yo
Y
Y
Yoshida
M
M
Saika
A
A
Suzuki
T
T
Yoshida
H
H
Ishibashi
H
H
Yamamoto
S
S
Nakamura
K
K
Kawaguchi
H
H
Yoshimura
N
N
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012737:Sex Factors; D055009:Spondylosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*