Spinal radiographic findings and nonspecific low back pain: A systematic review of observational studies

Maurits W. Van Tulder*, Willem J.J. Assendelft, Bart W. Koes, Lex M. Bouter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

384 Citations (Scopus)

Abstract

Study Design. A systematic review of published observational studies. Objectives. To examine the causal relationship between radiographic findings and nonspecific low back pain. Summary of Background Data. The causal relationship between radiographic findings and nonspecific low back pain still is controversial. Methods. Two reviewers independently scored the methodologic quality of all relevant, available studies using a standardized set of criteria. The association between radiographic findings and nonspecific low back pain was expressed as an odds ratio with a corresponding 95% confidence interval. Results. Degeneration, defined by the presence of disc space narrowing, osteophytes, and sclerosis, turned out to be associated with nonspecific low back pain with odds ratios ranging from 1.2 to 3.3. Spondylolysis and spondylolisthesis, spina bifida, transitional vertebrae, spondylosis, and Scheuermann's disease did not appear to be associated with low back pain. The validity scores of the observational studies ranged from 0% to 91% of the maximum score. Only two studies used a prospective design, and most studies lacked control for confounding, an appropriate test for nonspecific low back pain, and blinded assessment of radiographs and low back pain status. Conclusions. There is no firm evidence for the presence or absence of a causal relationship between radiographic findings and nonspecific low back pain.

Original languageEnglish
Pages (from-to)427-434
Number of pages8
JournalSpine
Volume22
Issue number4
DOIs
Publication statusPublished - 15 Feb 1997

Fingerprint

Dive into the research topics of 'Spinal radiographic findings and nonspecific low back pain: A systematic review of observational studies'. Together they form a unique fingerprint.

Cite this