ACUTE LOW BACK PAIN

Objectives: X ray of the lumbosacral spine is widely used in our clinical settingearly on in the management of patients presenting with nonspecific acute low back pain. Thispractice is in contradiction to the clinical practice guidelines however patient satisfaction isusually the main motive declared by clinicians following this practice. This study was conductedto detect the radiologic prevalence of the most commonly diagnosed congenital anomaliesin lumbosacral spine X rays done for patients presenting with nonspecific acute low backpain. Study Design & Setting: Prospective descriptive study at Shalamar Hospital Lahore,Pakistan. Duration of Study: Six months from September 2014 to February 2015. Subjectsand Methods: Radiographs of 400 patients presenting with non-specific acute low back painand fulfilling the inclusion / exclusion criteria were examined. Data was analyzed on SPSSversion 13 and percentage and frequency of patients with non-specific acute low back painwith 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 rangedfrom 15 to 36 years with mean age of 28 (SD ±4.84). 145 patients (36.25%) were found to havecongenital 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 prevalenceof lumbosacral transitional vertebra (LSTV) and spondylolysis in Pakistani patients presentingwith non-specific acute low backache, compared to that quoted in literature. This arguably mayconstitute a convincing argument in favor of obtaining lumbosacral spine X-rays early on in themanagement of young patients presenting with non-specific acute low backache.