Aberrant intervertebral motion in patients with treatment‑resistant nonspecific low back pain: a retrospective cohort study and control comparison.

Breen, A. C., Mellor, F. E. and Breen, A. C., 2018. Aberrant intervertebral motion in patients with treatment‑resistant nonspecific low back pain: a retrospective cohort study and control comparison. European Spine Journal. (In Press)

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Official URL: http://link.springer.com/

DOI: 10.1007/s00586-018-5666-1

Abstract

Purpose Intervertebral kinematic assessments have been used to investigate mechanical causes when back pain is resistant to treatment, and recent studies have identified intervertebral motion markers that discriminate patients from controls. However, such patients are a heterogeneous group, some of whom have structural disruption, but the effects of this on intervertebral kinematics are unknown.Methods Thirty-seven patients with treatment-resistant back pain referred for quantitative fluoroscopy were matched to an equal number of pain-free controls for age and sex. All received passive recumbent flexion assessments for intervertebral motion sharing inequality (MSI), variability (MSV), laxity and translation. Comparisons were made between patient sub-groups, between patients and controls and against normative levels from a separate group of controls.Results Eleven patients had had surgical or interventional procedures, and ten had spondylolisthesis or pars defects. Sixteen had no disruption. Patients had significantly higher median MSI values (0.30) than controls (0.27, p = 0.010), but not MSV (patients 0.08 vs controls 0.08, p = 0.791). Patients who received invasive procedures had higher median MSI values (0.37) than those with bony defects (0.30, p = 0.018) or no disruption (0.28, p = 0.0007). Laxity and translation above reference limits were not more prevalent in patients.Conclusion Patients with treatment-resistant nonspecific back pain have greater MSI values than controls, especially if the former have received spinal surgery. However, excessive laxity, translation and MSV are not more prevalent in these patients. Thus, MSI should be investigated as a pain mechanism and for its possible value as a prognostic factor and/or target for treatment in larger patient populations.

Item Type:Article
ISSN:0940-6719
Uncontrolled Keywords:Back pain; Spinal surgery; Kinematics; Fluoroscopy; Diagnosis
Group:Faculty of Science & Technology
ID Code:30890
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:21 Jun 2018 15:28
Last Modified:10 Oct 2018 12:17

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