Document Detail


MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain.
MedLine Citation:
PMID:  15454707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A cross-sectional analysis of the feeding arteries of the lumbar spine and cholesterol levels on patients with long-term nonspecific lower back pain. OBJECTIVES: To evaluate whether occlusion of lumbar and middle sacral arteries or serum cholesterol levels are associated with lower back pain and/or with disc degeneration. SUMMARY OF BACKGROUND DATA: Atherosclerosis in the wall of the abdominal aorta usually develops at the ostia of branching arteries and the bifurcation, and may obliterate orifices of lumbar and middle sacral arteries. Obstruction of these arteries causes ischemia in the lumbar spine and may result in back symptoms and disc degeneration. METHODS: MR aortography and cholesterol blood tests were performed on 51 patients with long-term lower back pain without specific findings (i.e., spinal or nerve root compression) in regular lumbar MR images. The patients ranged from 35 to 70 years of age (mean age, 56 years). Serum cholesterol and low-density lipoprotein (LDL) cholesterol levels were measured. To assess symptoms and disability NASS low back Outcome Instrument was used. RESULTS: Twenty-nine (78%) of 37 men and 11 (77%) of 14 women showed occluded lumbar and/or middle sacral arteries. The prevalence of occluded arteries was 2.5 times more than in subjects of corresponding age group in a Finnish necropsy material. Twenty-three (62%) men and seven (50%) women had significant disc degeneration. Disc degeneration was associated with occluded lumbar/middle sacral arteries (P = 0.035). Patients with occluded arteries or significant disc degeneration did not complain more severe symptoms than those without, whereas patients with above normal serum LDL cholesterol scored higher in neurogenic symptoms (P = 0.031) and complained more often severe pain (P = 0.049) than those with normal LDL cholesterol. CONCLUSIONS: The study indicates that lumbar and middle sacral arteries are often occluded in patients with nonspecific long-term lower back pain. Occlusion of these arteries may also be associated with disc degeneration.
Authors:
Leena I Kauppila; Raija Mikkonen; Pekka Mankinen; Kia Pelto-Vasenius; Ilkka Mäenpää
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  29     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-29     Completed Date:  2005-10-06     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2147-52     Citation Subset:  IM    
Affiliation:
Departments of Rehabilitation, Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland. leena.kauppila@hus.fi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cholesterol / blood*
Cross-Sectional Studies
Female
Humans
Intervertebral Disk / blood supply,  radiography
Low Back Pain / blood,  etiology*
Lumbosacral Region / blood supply,  radiography*
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Spinal Diseases / blood,  radiography
Time*
Chemical
Reg. No./Substance:
57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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