Assessment of lower back pain using lumbar spine radiography

Abstract

Lower back pain is a very common public health problem throughout the world, as it will affect three quarters of all humans in some point of their life. It’s causes vary considerably, from simple muscle sprain to metastatic malignancy. This descriptive study was conducted in Khartoum state to assess the role of lumbar radiographs in patients with acute and sub-acute lower back pain. Anteroposterior and lateral radiographs of 83 subjects (40 males and 43 females) were evaluated for lumbar lordosis, lumbosacral junctions disc height and angle, vertebral body condition and alignment for features associated with lower back pain. The results of this study showed an average of 50.7o (SD=11.1) in lumbar lordosis angle, with males showing lower angles and a slight increase with age. The average height of L5/S1 intervertebral disc was 1.2 cm, higher in men and did not affect any of the other parameters measured; Lumbosacral junction disc angles average was 14.5o and increased steadily with age. A serious degree of Spondylolisthesis was uncommon, the majority of cases were of the first grade (39 of 48), however Schmorl's node and osteophytes were common (30 % and 47%), but transitional vertebra and spinal canal stenosis were not. It was concluded that major causes of lower back pain are rarely shown on lumbar radiographs taken in the first two months of the onset, and considering the financial aspects and radiation dose, it becomes apparent that adhering to the recommended guidelines dictating that lumbar radiographs for non-specific LBP should be taken only for patients with clinically identified “red flags”