Do osteoporosis and spinal degenerative disorders affect low back pain and related disorders? The Wakayama Spine Study

Abstract

Abstract This study aimed to evaluate the coexistence of osteoporosis (OP) and spinal degenerative disorders in the general population, determine the factors influencing low back pain (LBP), and how they impact the activities of daily living (ADL) and physical performance in older individuals with multiple comorbidities. This cross-sectional study was part of a large-scale population-based cohort study in Japan, involving 1,009 participants who underwent spinal magnetic resonance imaging (MRI) to assess cervical cord compression, radiographic lumbar spinal stenosis, and lumbar disc degeneration. Vertebral fractures (VF) in the thoracolumbar spine were evaluated using sagittal MRI with a semi-quantitative method. Bone mineral density was measured using dual-energy X-ray absorptiometry. LBP, Oswestry Disability Index (ODI), and physical performance tests, such as one-leg standing time, five times chair-stand time, maximum walking speed, and maximum step length, were assessed. Using clinical conditions as objective variables and image evaluation parameters as explanatory variables, multiple regression analysis showed that VF was significantly associated with LBP and ODI. VF and OP were significantly associated with physical performance, whereas OP alone was not significantly associated with LBP or ODI (all P<0.05). Our findings contribute to new insights on LBPand its impact on ADL and physical performance.