A systematic review 1 including 31 studies (only two prospective) was abstracted in DARE. The ORs of the association between degeneration ad low back pain ranged from 1.21 to 3.32, with most 95% CIs not including 1, indicating a statistically significant positive association. The ORs for spondylolysis and spondylolisthesis ranged from 0.33 to 2.12, with most CIs including 1. Only a few studies of acceptable quality reported on the association between spina bifida, transitional vertebrae, spondylosis, and Scheuermann´s disease. In general, these findings were not associated with non-specific low back pain.
A technology assessment report 2 on the use of plain radiography in low back pain was abstracted in the Health Technology Assessment Database. The assessment consisted of a RCT of 153 patients and an observational study with 506 patients. In the RCT, referral to lumbar spine x-ray led to a small improvement in patient psychological well-being, but there were no differences in physical outcomes. The authors conclude that there are few significant diffrences at 6 weeks or 1 year between patients who are referred to x-ray and those who are not. Referring to x-ray leads to higher costs.
Primary/Secondary Keywords