Evaluation of congenital lumbosacral malformations and neurological findings in patients with low back pain

Turk Neurosurg. 2009 Apr;19(2):145-8.

Abstract

Aim: To investigate the correlation of congenital lumbosacral abnormalities with neurological signs in young patients with low back pain (LBP) MATERIAL AND METHODS: The study included 401 patients with LBP that lasted longer than 2 weeks. All cases were screened by standard lumbosacral x-rays for the presence of the most common congenital vertebral abnormalities i.e. spina bifida occulta (SBO) and transitional vertebra (TV). Patients were divided into two groups according to presence of a neurological sign. Patients with a neurological sign were referred for computerized tomography and/or magnetic resonance imaging.

Results: Sixty-two patients had a neurological sign. Congenital vertebral abnormalities were detected in 52 patients (12.1%); 34 of these (8.5%) were spina bifida, whereas 18 (4.5%) were transitional vertebra. SBO was most commonly observed at the S1 level (30 patients). No correlation for SBO or TV was determined in patients with and without neurological signs but these groups showed significant difference for disc herniation in CT or MRI (P=0.001). Congenital abnormalities had no correlation with disc herniation in CT or MRI.

Conclusion: LBP in young adults with TV or SBO showed no correlation with neurological signs. Therefore patients with prolonged LBP that present with neurological signs may be scheduled for CT and/or MRI, but reevaluation of the patient with psychometric tests is recommended if there is no neurological sign.

MeSH terms

  • Adult
  • Humans
  • Low Back Pain / congenital
  • Low Back Pain / diagnostic imaging*
  • Low Back Pain / pathology
  • Lumbar Vertebrae / abnormalities*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Magnetic Resonance Imaging
  • Male
  • Sacrum / abnormalities*
  • Sacrum / diagnostic imaging
  • Sacrum / pathology
  • Spina Bifida Occulta / diagnostic imaging*
  • Spina Bifida Occulta / pathology
  • Tomography, X-Ray Computed
  • Young Adult