Relationship between Disability and Radiographic Findings of Lumbar Disc Degeneration in Sample of Iraqi Patients with Mechanical Low Backache

  • Khudair Al-Bedri College of Medicine, University of Baghdad, Baghdad, Iraq
  • Riyam Ali Meften
  • zainab abdullah mahmood Basra College of Medicine

Abstract

Background: Disability related to chronic low back pain is a complex and multidimensional phenomenon all over the world. Aims of study: To evaluate the associations of x-ray features of lumbar disk degeneration with severity of disability among patients with mechanical low back pain. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical low back pain. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0 -10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar x-rays. Results: the mean age of our sample was 52.45 ± 7.87. The findings of disc space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two third of cases were focused on minimal disability followed by moderate, severe, and crippled as (26%), (6%) and (2%) respectively. There was highly significant association between women and pain radiation to legs (p-value=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disc space narrowing on x-ray and disc degenerative disease score on x-ray, while age, presence of osteophytes and spondylolisthesis, body mass index and pain duration were not associated with severity of disability.

Keywords: back pain, lumbar disc degeneration, disability

References

1- Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The lancet. 2012; 379(9814):482-91.
2- Hüllemann P, Keller T, Kabelitz M, Gierthmühlen J, Freynhagen R, Tölle T, Forsten pointner J, Baron R. Clinical Manifestation of Acute, Subacute, and Chronic Low Back Pain in Different Age Groups: Low Back Pain in 35,446 Patients. Pain Practice. 2018 Nov;18(8):1011-23.
3- Resnick DK, Choudhri TF, Dailey AT, et al. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: fusion in patients with stenosis and spondylolisthesis. Journal of Neurosurgery: Spine. 2005; 2(6):679-85.
4- World Health Organization, International Classification of impairments, disabilities and handicaps: A manual of classification relating to the consequences of disease (Geneva, 1980).
5- Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012; 380(9859):2163-96.
6- Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388(10053):1545-602.
7- Hoy DG, Smith E, Cross M, et al. Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the global burden of disease 2010 study and the next steps forward. Annals of the rheumatic diseases. 2015;74(1):4-7.
8- Reigo T, Timpka T, Tropp H. The epidemiology of back pain in vocational age groups. Scandinavian Journal of Primary Health Care. 1999(1):17-21.
9- Fairbank JC, Couper J, Davies JB, O’brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3.
10- Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000;25(22):2940-53.
11- Boonstra AM, Stewart RE, Köke AJ, et al. Cut-off points for mild, moderate, and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain: variability and influence of sex and catastrophizing. Frontiers in psychology. 2016;7:1466.
12- Emiliano NV , Luiz Roberto GV, Christiano ES, Phelipe de Souza M. Clinical-radiographic correlation of degenerative changes of the spine-systemic review. Coluna/Columna. 2016;15(4), 325-329.
13- Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000; 25(22):2940-52; discussion 52.
14- World Health Organization. Obesity and overweight : fact sheet,
http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Accessed at 12/7/2018, 10:00 pm.
15- Bydon M, Alvi MA, Goyal A. Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurgery Clinics. 2019; 30(3):299-304.
16- Biglarian A, Seifi B, Bakhshi E, et al. Low back pain prevalence and associated factors in Iranian population: findings from the national health survey. Pain research and treatment. 2012;2012.
17- Shiri R, Karppinen J, Leino-Arjas P, et al. The association between obesity and low back pain: a meta-analysis. American journal of epidemiology. 2009;171(2):135-54.
18- Ahdhi GS, Subramanian R, Saya GK, Yamuna TV. Prevalence of low back pain and its relation to quality of life and disability among women in rural area of Puducherry, India. Indian Journal of Pain. 2016;30(2):111.
19- .Koley S, Sandhu NK. An association of body composition components with the menopausal status of patients with low back pain in Tarn Taran, Punjab, India. Journal of Life Sciences. 2009;1(2):129-32.
20- Craft RM, Mogil JS, Aloisi AM. Sex differences in pain and analgesia: the role of gonadal hormones. European journal of pain. 2004;8(5):397-411.
21- Galukande M, Muwazi S, Mugisa BD. Disability associated with low back pain in Mulago Hospital, Kampala Uganda. African health sciences. 2006;6(3):173-6.
22- Wang YX, Griffith JF. Effect of menopause on lumbar disk degeneration: potential etiology. Radiology 2010;257:318-20.
23- Wang YX, Griffith JF, Ma HT, et al. Relationship between gender, bone mineral density, and disc degeneration in the lumbar spine: a study in elderly subjects using aneight-level MRI-based disc degeneration grading system. Osteoporos Int 2011;22:91-6.
24- Wáng YX. Postmenopausal Chinese women show accelerated lumbar disc degeneration compared with Chinese men. Journal of Orthopaedic Translation 2015;3:205-11.
25- La Touche R, Pérez-Fernández M, Barrera-Marchessi I, et al. Psychological and physical factors related to disability in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation. 2018 Dec 11.
26- AL-Jumaily HF. Assessment of Individual Radiographic Features of Lumber Disc Degeneration Influenced by Age, Gender and Vertebral Level. Iraqi Journal Of Community Medicine. 2013;26 (2):129-36.
27- Peterson CK, Bolton JE, Wood AR. A cross-sectional study correlating lumbar spine degeneration with disability and pain. Spine. 2000 Jan 15;25(2):218.
28- Andersson GB. Epidemiological features of chronic low-back pain. The lancet. 1999;354(9178):581-5.
29- Güler M, Çapk?n E, Barçak ÖF, et al. The association between radiographic features in patients with lumbar spine degenerative changes and body mass index; a preliminary stereological study. Nobel Medicus. 2013;9:9-13.
30- Perera RS, Dissanayake PH, Senarath U, et al. Associations between disc space narrowing, anterior osteophytes and disability in chronic mechanical low back pain: a cross sectional study. BMC musculoskeletal disorders. 2017; 18(1):193
31- Ren XS, Selim AJ, Fincke G, et al. Assessment of functional status, low back disability, and use of diagnostic imaging in patients with low back pain and radiating leg pain. Journal of clinical epidemiology. 1999;52(11):1063-71.
32- Konstantinou K, Hider SL, Jordan JL, et al. The impact of low back-related leg pain on outcomes as compared with low back pain alone: a systematic review of the literature. The Clinical journal of pain. 2013;29(7):644-54.
33- Konstantinou K, Dunn KM, Ogollah R, et al. Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. BMC musculoskeletal disorders. 2015;16(1):332.
34- Pye SR, Reid DM, Lunt M, et al. Lumbar disc degeneration: association between osteophytes, end-plate sclerosis and disc space narrowing. Annals of the rheumatic diseases. 2007;66(3):330-3.
35- De Schepper EI, Damen J, van Meurs JB, et al. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine. 2010;35(5):531-6
36- Kettler A, Wilke HJ. Review of existing grading systems for cervical or lumbar disc and facet joint degeneration. European Spine Journal. 2006;15(6):705-18.
37- Goode AP, Marshall SW, Renner JB, et al. Lumbar spine radiographic features and demographic, clinical, and radiographic knee, hip, and hand osteoarthritis. Arthritis care & research. 2012;64(10):1536-44.
38- Ashraf A, Farahangiz S, Jahromi BP, et al. Correlation between degree of radiologic signs of osteoarthritis and functional status in patients with chronic mechanical low back pain. The Malaysian journal of medical sciences: MJMS. 2014;21(2):28.
39- Webb R, Brammah T, Lunt M, et al. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine. 2003;28(11):1195-202.
40- Salvetti MD, Pimenta CA, Braga PE, Corrêa CF. Disability related to chronic low back pain: prevalence and associated factors. Revista da Escola de Enfermagem da USP. 2012;46(SPE):16-23.
41- Möller H, Sundin A, Hedlund R. Symptoms, signs, and functional disability in adult spondylolisthesis. Spine. 2000;25(6):683-90.
42- Petersen T, Laslett M, Juhl C. Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews. BMC musculoskeletal disorders.2017;18(1):188.
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Al-Bedri, K., R. A. Meften, and zainab abdullah mahmood. “Relationship Between Disability and Radiographic Findings of Lumbar Disc Degeneration in Sample of Iraqi Patients With Mechanical Low Backache”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 14, no. 2, Feb. 2021, https://innovareacademics.in/journals/index.php/ajpcr/article/view/40166.
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