A cross-sectional study correlating lumbar spine degeneration with disability and pain

Study Design. Cross-sectional design. Objectives. To investigate the correlation between degeneration in the lumb ar spine and self-reported disability and pain levels in patients with and without a history of trauma. Summary of Background Data. The link between lumbar spine degeneration and low back pain remains controversial, as does the correlation between trauma nad spinal degeneration. Methods. Radiographic and questionnaire data were collected from 172 consec utive patients with low back pain. Back pain severity was measured using tw o scales: one for pain over the entire episode and one for pain during the previous week. All patients also completed the Revised Oswestry Disability Questionnaire before radiography was performed. Further questions concernin g the chronicity of symptoms and trauma were included. Results. Controlling for age, patients with low back pain with a history of trauma had a statistically significant increase in the severity of facet d egeneration (P < 0.02) compared with nontrauma patients with low back pain. However, there was no difference in disability and pain scores between the trauma and nontrauma patients or between the genders. A weak correlation b etween pain and severity rating and the number of levels of degeneration an d the severity of the degeneration at the disc and facets was noted. Conclusions. Patients with low back pain with a history of trauma had more severe facet arthrosis than do nontrauma patients with low back pain, but t here were no differences in pain and disability. There was a weak correlati on between the quantity and severity of lumbar degeneration with pain level s, but not with disability scores. These findings are discussed in the ligh t of recent reports regarding the cervical spine.