J Korean Neurosurg Soc.  2017 Jan;60(1):67-74. 10.3340/jkns.2016.0505.007.

Prevalence and Risk Factors for Lumbar Spondylosis and Its Association with Low Back Pain among Rural Korean Residents

• Lee SY
• Cho NH
• Jung YO
• Seo YI
• Kim HA

• KMID: 2365589
• DOI: http://doi.org/10.3340/jkns.2016.0505.007

Abstract

OBJECTIVE
The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender.
METHODS
This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied.
RESULTS
Of 4261 subjects aged 40-79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ≥2 osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ≥2 spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender.
CONCLUSION
Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.

Keyword

Prevalence; Risk factors; Lumbar spondylosis; Lower back pain

MeSH Terms

Aged
Arthritis
Back Pain
Cross-Sectional Studies
Female
Hand
Humans
Knee
Low Back Pain*
Male
Osteophyte
Prevalence*
Risk Factors*
Spine
Spondylosis*

Figure

• 

  Fig. 1 Linear by linear association between individual radiographic features of lumbar spondylosis and ODI. The graph shows signiÿcantly positive linear association (*p <0.0001) after adjustment for age and gender. ODI: Oswestry disability index, JSN: joint-space narrowing, KL: Kellgren-Lawrence.

Reference

References

1. Battié MC, Videman T, Gibbons LE, Fisher LD, Manninen H, Gill K. 1995 Volvo Award in clinical sciences. Determinants of lumbar disc degeneration A study relating lifetime exposures and magnetic resonance imaging findings in identical twins. Spine (Phila Pa 1976). 20:2601–2612. 1998.

2. Cho NH, Jung YO, Lim SH, Chung CK, Kim HA. The prevalence and risk factors of low back pain in rural community residents of Korea. Spine (Phila Pa 1976). 37:2001–2010. 2012.

3. de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A, et al. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine (Phila Pa 1976). 35:531–536. 2010.

4. Hangai M, Kaneoka K, Kuno S, Hinotsu S, Sakane M, Mamizuka N, et al. Factors associated with lumbar intervertebral disc degeneration in the elderly. Spine J. 8:732–740. 2008.

5. Jhun HJ, Park JY. Estimated number of korean adults with back pain and population-based associated factors of back pain: data from the fourth Korea national health and nutrition examination survey. J Korean Neurosurg Soc. 46:443–450. 2009.

6. Jeon CH, Kim DJ, Kim SK, Kim DJ, Lee HM, Park HJ. Validation in the cross-cultural adaptation of the Korean version of the Oswestry Disability Index. J Korean Med Sci. 21:1092–1097. 2006.

7. Lane NE, Nevitt MC, Genant HK, Hochberg MC. Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration. J Rheumatol. 20:1911–1918. 1993.

8. Muraki S, Oka H, Akune T, Mabuchi A, En-Yo Y, Yoshida M, et al. Prevalence of radiographic lumbar spondylosis and its association with low back pain in elderly subjects of population-based cohorts: the ROAD study. Ann Rheum Dis. 68:1401–1406. 2009.

9. Pye SR, Reid DM, Smith R, Adams JE, Nelson K, Silman AJ, et al. Radiographic features of lumbar disc degeneration and self-reported back pain. J Rheumatol. 31:753–758. 2004.

10. Robinson ME, Dannecker EA, George SZ, Otis J, Atchison JW, Fillingim RB. Sex differences in the associations among psychological factors and pain report: a novel psychophysical study of patients with chronic low back pain. J Pain. 6:463–470. 2005.

11. Suri P, Miyakoshi A, Hunter DJ, Jarvik JG, Rainville J, Guermazi A, et al. Does lumbar spinal degeneration begin with the anterior structures? A study of the observed epidemiology in a community-based population. BMC Musculoskelet Disord. 12:202. 2011.

12. van Tulder MW, Assendelft WJ, Koes BW, Bouter LM. Spinal radiographic findings and nonspecific low back pain. A systematic review of observational studies. Spine (Phila Pa 1976). 22:427–434. 1997.

13. Wang YX, Griffith JF, Ma HT, Kwok AW, Leung JC, Yeung DK, et al. Relationship between gender, bone mineral density, and disc degeneration in the lumbar spine: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system. Osteoporos Int. 22:91–96. 2011.

14. Yoshida S, Aoyagi K, Felson DT, Aliabadi P, Shindo H, Takemoto T. Comparison of the prevalence of radiographic osteoarthritis of the knee and hand between Japan and the United States. J Rheumatol. 29:1454–1458. 2002.

15. Yoshimura N, Dennison E, Wilman C, Hashimoto T, Cooper C. Epidemiology of chronic disc degeneration and osteoarthritis of the lumbar spine in Britain and Japan: a comparative study. J Rheumatol. 27:429–433. 2000.

16. Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 27:620–628. 2009.

17. Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, et al. Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Arthritis Rheum. 44:2065–2071. 2001.