Internal Med Medical News about Low Back Pain Range of Motion, Articular

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A Comparative MRI Study of Upper and Lower Lumbar Motion Segments in Patients With Low Back Pain
Journal of Spinal Disorders & Techniques, 10/05/09

Saberi H et al. – The study revealed that pathological alteration in vertebral end plates is the same in upper and lower lumbar bony tissues as detected by Modic's criteria, whereas those of intervertebral discs is different regarding spinal level and risk factor.

Methods

514 patients with low back pain of at least 4 weeks duration, aged 18 to 70 years were prospectively enrolled.
All underwent thorough neurological assessment and lumbar 1.5 T high–resolution magnetic resonance imaging, being evaluated by independent neurosurgeon and neuroradiologists.
Nucleus pulposus (NP) dislodgement and Modic changes as well as neurological findings were graded.
Statistical analysis was performed by analysis of variance, t test, ?2, and Fisher exact test.

Results

There were 244 men and 270 women. 66 percent of lower lumbar levels showed NP dislodgement at least in 1 level.
Aging had significant association with NP dislodgement, and patients with lower lumbar NP dislodgement had a mean age, 10 years younger than those with upper lumbar NP dislodgement.
There was no significant association between sex, body mass index >25 kg/m2, and vibratory job either in upper or lower lumbar levels and NP degeneration.
Heavy lifting was associated with upper lumbar NP dislodgement while, sedentary and housework were associated with NP dislodgement only in lower lumbar levels.
Also cigarette smoking (>=10 pack/y) and older age (>50 y) were associated only with upper lumbar NP dislodgement.
Modic changes correlated only with advanced age (>50 y), and there was no association with body mass index >25, smoking, job habits and sex.