J Korean Orthop Assoc.
1979 Sep;14(3):532-540. 10.4055/jkoa.1979.14.3.532.
Clinical Study of Low Back Pain
- KMID: 2460299
- DOI: http://doi.org/10.4055/jkoa.1979.14.3.532
Abstract
- Low back pain has been recognized as a general symptom rather than a specific disease entity, especially when musculoskeletal lesions of the low back, hysteric conversion symptoms and visceral lesions are present. Today, the development of industry, the complexity of living methods and the execution of medical insurance have increased the number of the patients who have low back pain. In view of the suggestion that the patients who have attacks of low back pain are increasing in our society, and that, at the present time, there is little clinical study of it, the author considered that a study of his current experience would be of some general interest. In this thesis the records of 413 in-patients, whose chief complaint was low back pain and who were treated as such at Han Yang University Hospital, Department of Orthopedics between the periods from May 1972 to April 1978, were studied. The following results can be recognized by observing and analyzing their charts, physical findings and X-ray findings. 1. Of the patients suffering from lumbago, 33.2% were caused by the discogenic origin. Thus, the discogenic orgin was the most common cause of Iumbago, and male:55.4%, female: 4.6%. 2. According to simple L-S spine X-ray findings of the discogenic origin, 35.8%, of the decrease of the lumbar lordotic curve; 30.7% of the narrowing of the intervertebral space. Besides them, some cases of the lumbar scoliosis, osteoarthritic changes, soteoporosis, Knuttson's phenomenon and Schmorls node were appeared. And, 15.3% though they were thought to be the discogenic origin according to their symptoms and the physical findings, had no specific abnormal findings, suggesting that the patients are relatively young and their duration of lumbago is short. 3. Of the lumbar disc herniation, the herniation between the fifth lumbar and the first sacrum was most frequently appeared, 49.5% and the herniation between the fourth lumbar and fifth lumbar formed 41.3%, and the herniation between the third and the fourth lumbar was 2.8%. 4. Of spondylolistheses, the highest proportion, 66.7%, occured in the fifth lumbar level. And in the degree of slipping, 96.3% came under the grade 1 of Meyerding's method. 5. The frequency of anomaly, among the patients with lumbago, appeared as follows; spina bifida formed 12.6%: sacralization, 8.0%: lumbarization, 4.6%: tropism, 3.6%. 6. Of the patients with discogenic origin, 91.2% were under conservative treatment and 8.8% were under operative treatment. 7. Of the patients with Tbc spine, 35.9% were under conservative treatment, and 64.1% under operative treatment. Among the methods of operation, curettage and anterior interbody fusion was 80%: posterior interbody fusion, 12%: incision and drainage, 8%. 8. In the treatment of spondylolistheses, 66.7% were under conservative treatment, and 33.3% under operative treatment. In the operatlve methods, 6 cases were performed by posterior spinal fuslon by H-sahped bone graft: and 3 cases, postero-lateral spinal fusion.
