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Chronic low back pain and its association with lumbar vertebrae and intervertebral disc changes in adults. A case control study.

Chronic low back pain and its association with lumbar vertebrae and intervertebral disc changes in adults. A case control study.
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Karunanayake AL, Pathmeswaran A, Wijayaratne LS,


Karunanayake AL, Pathmeswaran A, Wijayaratne LS, (click to view)

Karunanayake AL, Pathmeswaran A, Wijayaratne LS,

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International journal of rheumatic diseases 2017 02 16() doi 10.1111/1756-185X.13026
Abstract
AIM
This study was done to determine the association between chronic low back pain and vertebral fractures, intervertebral disc space (IDS) narrowing, vertebral osteophytes and spondylolisthesis among adults.

METHOD
This case control study was done in Sri Lanka. Cases were patients with low back pain and controls were without low back pain. Postero-anterior and lateral radiographs of lumbar sacral spine of both groups were studied. To detect vertebral fractures in fourth and fifth lumbar vertebrae, anterior and posterior heights of vertebrae were measured using a Vernier caliper and antero-posterior ratio (A/P) was calculated. Having an A/P ratio value of < 0.89 was considered as a vertebral fracture. Presence of disc space narrowing, vertebral osteophytes and spondylolisthesis was assessed by two radiologists working independently. Bivariate and logistic regression analysis was done to find associations. RESULTS
There were 140 cases and 140 controls. Mean (SD) age for cases was 51.6 (17) years. Mean (SD) age for controls was 50 (15) years. Females made up 62% of cases and controls. Fifth lumbar vertebral fracture (odds ratio [OR] = 10.2; P = 0.001), fourth lumbar vertebral fracture (OR = 2.5; P = 0.017) and IDS narrowing (OR = 4.15, P = 0.009) had a significant association with low back pain and vertebral osteophytes and spondylolisthesis did not have a significant association with low back pain.

CONCLUSION
Only vertebral fractures and IDS narrowing had a significant association with chronic low back pain.

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