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Prevalence of radiographic lumbar spondylosis and its association with low back pain in the elderly of population-based cohorts: the ROAD study
  1. Shigeyuki Muraki
  1. 22nd Century Medical & Research Center, University of Tokyo, Japan
    1. Hiroyuki Oka
    1. 22nd Century Medical & Research Center, University of Tokyo, Japan
      1. Toru Akune
      1. 22nd Century Medical & Research Center, University of Tokyo, Japan
        1. Akihiko Mabuchi
        1. 22nd Century Medical & Research Center, University of Tokyo, Japan
          1. Yoshio En-yo
          1. Orthopaedic Surgery, Wakayama Medical University, Japan
            1. Muneto Yoshida
            1. Orthopaedic Surgery, Wakayama Medical University, Japan
              1. Akihiko Saika
              1. Orthopaedic Surgery, Wakayama Medical University, Japan
                1. Takao Suzuki
                1. Tokyo Metropolitan Institute of Gerontology, Japan
                  1. Hideyo Yoshida
                  1. Tokyo Metropolitan Institute of Gerontology, Japan
                    1. Hideaki Ishibashi
                    1. Tokyo Metropolitan Institute of Gerontology, Japan
                      1. Seizo Yamamoto
                      1. Tokyo Metropolitan Institute of Gerontology, Japan
                        1. Kozo Nakamura
                        1. Sensory & Motor System Medicine, University of Tokyo, Japan
                          1. Hiroshi Kawaguchi (kawaguchi-ort{at}h.u-tokyo.ac.jp)
                          1. Sensory & Motor System Medicine, University of Tokyo, Japan
                            1. Noriko Yoshimura
                            1. 22nd Century Medical & Research Center, University of Tokyo, Japan

                              Abstract

                              Objectives: Although lumbar spondylosis is a major cause of low back pain and disability in the elderly, few epidemiologic studies have been performed. We investigated the prevalence of radiographic lumbar spondylosis using a large-scale population, and examined the association with low back pain.

                              Methods: From a nationwide cohort study ROAD (Research on Osteoarthritis Against Disability), 2,288 participants (≥60 years; 818 men and 1,470 women) living in urban, mountainous and seacoast communities were analyzed. The radiographic severity at lumbar intervertebral levels from L1/2 to L5/S was determined by the Kellgren/Lawrence (KL) grading.

                              Results: In the overall population, prevalence of radiographic spondylosis with KL≥2 and ≥3 at the severest intervertebral level was 75.8 and 50.4%, respectively, and that of low back pain was 28.8%. Although the KL≥2 spondylosis was more prevalent in men, the KL≥2 spondylosis and low back pain were more prevalent in women. Age and body mass index were risk factors for both KL≥2 and KL≥3 spondylosis. Although KL=2 spondylosis was not significantly associated with low back pain compared to KL=0 or 1, KL≥3 spondylosis was related to the pain only in women.

                              Conclusions: The present cross-sectional study using a large population revealed a high prevalence of radiographic lumbar spondylosis in the elderly. Gender seems to be distinctly associated with KL≥2 and KL≥3 lumbar spondylosis, and disc space narrowing with or without osteophytosis in women may be a risk factor for low back pain.

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