Association of atherosclerosis with low back pain and the degree of disc degeneration

Study Design. This was a cross-sectional observational study in which the a bdominal aorta was evaluated for atheromatous lesions visible in computed t omographic scans in patients with and without low back pain. Objectives. To evaluate whether patients with low back pain have more ather osclerosis in the abdominal aorta than patients without low back pain and w hether the severity of atherosclerosis in the abdominal aorta correlates wi th the grade of disc damage. Summary of Background Data. There are studies in which results indicate tha t insufficient blood supply may be a significant causative factor in disc d egeneration. There are also studies in which smoking, one of the risk facto rs for arterial disease, has been correlated with low back pain. Calf pain has also been shown to correlate with low back pain. Results in a long-term follow-up study have further indicated an association between disc disease s and fatal ischemic heart disease. However, there seems to be only one pos tmortem study in which results show an association between atherosclerosis in the arteries of the lumbar area and disc diseases. Methods. Computed tomographic images of 29 patients with low back pain, who had been evaluated with computed tomographic discography for diagnostic pu rposes, were evaluated for the quantity of atherosclerotic calcifications v isible on computed tomographic scans of the abdominal aorta. A similar eval uation was performed in an age- and sex-matched control group of 52 patient s without low back pain selected from among the patients referred for abdom inal computed tomography. Results. Sixteen (55%) of the 29 patients with low back pain had atheroscle rotic calcifications visible on computed tomographic scans, whereas 11 (21% ) of the 52 age-matched patients without low back pain were found to have a ortic calcifications. Eleven (48%) patients with low back pain who were 50 years of age or less (n = 23) had aortic calcifications, whereas only 3 (8% ) of the 36 control patients aged less than 50 years had aortic calcificati ons. There was no correlation between the amount of calcifications and the degree of disc degeneration assessed by computed tomographic discography. Conclusions. A significant association is indicated between atheromatous le sions in the abdominal aorta and low back pain.