Obesity found to be strong predictor of lumbar spine degeneration, low back pain
Published results showed obesity was a strong predictor of both the incidence and worsening of lumbar spine degeneration and low back pain.
Researchers graded paired baseline and follow-up lumbar spine radiographs from the Johnston County Osteoarthritis Project for osteophytes, disc space narrowing, spondylolisthesis and the presence of facet joint OA. Researchers collected patients’ self-reported low back pain, comorbidities and back injury, and defined spine OA as at least mild osteophytes and mild disc space narrowing at the same level for any level of the lumbar spine. Researchers estimated hazard ratios and 95% confidence intervals of spine phenotypes accounting for potential predictors, including demographics, clinical characteristics, comorbidities, obesity and appendicular OA.
Results showed 59% of patients developed osteophytes at any level of the lumbar spine. Researchers found similar incidences of disc space narrowing and spine OA at 38.1% and 31.4%, respectively, as well as incidences of facet joint OA at 10.2% and of spondylolisthesis at 9.1%. Researchers noted approximately 34% of participants had a worsening of osteophytes, 24% had a worsening of disc space narrowing and 8% had a worsening of spondylolisthesis.
According to results, obesity was a risk factor for incidence of disc space narrowing, facet joint OA, spine OA, spondylolisthesis and low back pain, as well as a risk factor for worsening disc space narrowing and low back pain. Although knee OA was a risk factors for the incidence of facet joint OA, researchers found hip and hand OA were not risk factors for radiographic changes in the lumbar spine. Researchers noted baseline osteophytes and spine OA were predictors of incident low back pain, while the presence of vertebral osteophytes and having mild of moderate low back pain at baseline were predictors for worsening low back pain. Results showed patients were 39% more likely to progress in low back pain severity if they had hip OA at baseline.
“These findings may have important implications for clinical practice, especially where diagnostic imaging is being used for better understanding the relationship between lumbar spine degeneration and [low back pain] LBP,” the authors wrote.