ACUTE LOW BACK PAIN

RADIOGRAPHIC PREVALENCE OF COMMON CONGENITAL LUMBOSACRAL SPINAL ANOMALIES IN YOUNG PATIENTS PRESENTING WITH NON SPECIFIC ACUTE LOW BACK PAIN

Abstract

Objectives: X ray of the lumbosacral spine is widely used in our clinical setting
early on in the management of patients presenting with nonspecific acute low back pain. This
practice is in contradiction to the clinical practice guidelines however patient satisfaction is
usually the main motive declared by clinicians following this practice. This study was conducted
to detect the radiologic prevalence of the most commonly diagnosed congenital anomalies
in lumbosacral spine X rays done for patients presenting with nonspecific acute low back
pain. Study Design & Setting: Prospective descriptive study at Shalamar Hospital Lahore,
Pakistan. Duration of Study: Six months from September 2014 to February 2015. Subjects
and Methods: Radiographs of 400 patients presenting with non-specific acute low back pain
and fulfilling the inclusion / exclusion criteria were examined. Data was analyzed on SPSS
version 13 and percentage and frequency of patients with non-specific acute low back pain
with lumbosacral transitional vertebra (LSTV), spina bifida and spondylolysis was calculated.
Results: Out of 400 patients 185 were males and 215 were females. Age of the patients ranged
from 15 to 36 years with mean age of 28 (SD ±4.84). 145 patients (36.25%) were found to have
congenital anomalies of lumbosacral vertebrae in question. The prevalence of LSTV was 19.5%
(78 patients), spina bifida was 10% (40 patients) and spondylolysis was 9% (36 patients). 2%
(9 patients) had more than one anomaly. Conclusions: This study shows a higher prevalence
of lumbosacral transitional vertebra (LSTV) and spondylolysis in Pakistani patients presenting
with non-specific acute low backache, compared to that quoted in literature. This arguably may
constitute a convincing argument in favor of obtaining lumbosacral spine X-rays early on in the
management of young patients presenting with non-specific acute low backache.