Evaluation of low back pain using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for lumbar spinal disease in a multicenter study: differences in scores based on age, sex, and type of disease.
BACKGROUND
The Japanese Orthopaedic Association (JOA) has investigated the JOA Back Pain Evaluation Questionnaire (JOABPEQ) to evaluate several aspects of low back pain in patients. The score includes five categories (25 items) selected from the Roland Morris Disability Questionnaire and Short Form 36, and a visual analogue scale. Japanese physicians have recently used these scores to evaluate back pain; however, the efficacy has not been fully explored in large-scale studies. In the current study, we used the JOABPEQ to evaluate lumbar spinal disease in 555 patients (with lumbar disc herniation, lumbar spinal stenosis, and lumbar disc degeneration/spondylosis) in multiple spine centers and compared the results based on age, sex, and type of disease.


METHODS
A total of 555 patients who had low back or leg pain were selected in 22 hospitals in Chiba Prefecture. Spine surgeons diagnosed their disease type based on symptoms, physical examination, radiography images, and magnetic resonance imaging. In all, 486 patients were diagnosed with spinal stenosis (239 patients), disc degeneration/spondylosis (143 patients), or disc herniation (104 patients). The other 69 patients were diagnosed with spondylolysis (16 patients) or other diseases (53 patients). The pain score in all patients was evaluated using the JOABPEQ (from 0 to 100, with 0 indicating the worst pain).


RESULTS
The age of the patients was 56.1 +/- 13.3 years (mean +/- SD); the age of patients in the disc herniation and disc degeneration/spondylosis group was significantly lower than that in the spinal stenosis group. The average JOABPEQ scores in all patients were, for low back pain, 47.1; lumbar function, 53.6; walking ability, 54.8; social life function, 48.7; and mental health, 48.3. The low back pain score in men was significantly worse than that in women. In contrast, the mental health score in women was significantly higher than that in men. The low back pain score in patients <40 years old and the walking ability score in patients >65 years old were significantly lower than those scores in other patients. Based on the disease type, low back pain, lumbar function, social life function, and mental health scores for patients with disc herniation were significantly worse than for those with spinal stenosis.


CONCLUSIONS
JOABPEQ scores were evaluated for several lumbar diseases. The average of five categories of JOABPEQ scores in all patients was similarly distributed. However, the average scores in the five categories were significantly different depending on age, sex, and type of disease. Compared with prior mass data (baseline data on the observational cohort of the Spine Patient Outcomes Research Trial in the United States), many data were similar based on the type of disease in the current study. Furthermore, the JOABPEQ is easy to use compared with the SF-36. Hence, we concluded that the JOABPEQ could be used worldwide as a tool for evaluating low back pain.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
Seiji
S
Ohtori
Toshinori
T
Ito
Masaomi
M
Yamashita
Yasuaki
Y
Murata
Tatsuo
T
Morinaga
Jiro
J
Hirayama
Tomoaki
T
Kinoshita
Hiromi
H
Ataka
Takana
T
Koshi
Toshihiko
T
Sekikawa
Masayuki
M
Miyagi
Takaaki
T
Tanno
Munetaka
M
Suzuki
Yasuchika
Y
Aoki
Takato
T
Aihara
Shinichiro
S
Nakamura
Kiyoshi
K
Yamaguchi
Toshiyuki
T
Tauchi
Kenji
K
Hatakeyama
Keiichi
K
Takata
Hiroaki
H
Sameda
Tomoyuki
T
Ozawa
Eiji
E
Hanaoka
Hirohito
H
Suzuki
Tsutomu
T
Akazawa
Kaoru
K
Suseki
Hajime
H
Arai
Masahiro
M
Kurokawa
Yawara
Y
Eguchi
Miyako
M
Suzuki
Yuzuru
Y
Okamoto
Jin
J
Miyagi
Masatsune
M
Yamagata
Tomoaki
T
Toyone
Kazuhisa
K
Takahashi
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D012720:Severity of Illness Index; D012737:Sex Factors; D013122:Spinal Diseases / Q000150:complications; D055815:Young Adult