Lumbar segmental instability as a cause of chronic low back pain

概要

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It is widely accepted that a decrease in compressive stiffness of the intervertebral disc in the degenerated spine may destabilize the motion segement and cause chronic low back pain. However, diagnostic standards of this condition, often referred to as segmental instability, remain obscure. The purpose of this study was to identify specific roentgenographic evidence that might indicate segmental instability.<BR>Roentgenographic measurements were made for comparison on ten parameters between the two following groups; "acute" low back pain group consisted of 30 patients and "chronic" low back pain group consisted of 26 patients. These 56 patients were selected from patients that had visited our outpatient clinic complaining of low back pain in 1988. Confirmation was made by telephone or by chart regarding duration of their symptom; patients were then classified into the two groups.<BR>Narrowing of the disc space (p=0.001), traction spur formation (p=0.01), wedging of the disc space (p=0.03) and scoliosis (p=0.02) were more commonly seen on the roentgenograms of the chronic low back pain group than on those of the acute low back pain group. There was no difference between the two groups with respect to the prevalence of claw spur formation, auterior slipping, posterior slipping, lateral slipping, posterior widening of the disc space or vertebral sclerosis adjacent to the end plate.
日本腰痛学会の論文