腰痛と腰椎変性所見の関連―疫学的検討

Correlation between Low Back Pain and Radiographic Findings of Lumbar Degeneration. An Epidemiologic Study

　2002年度福島県南会津郡舘岩村（現南会津町）の総合検診を受診した65歳以上の高齢者を対象に，問診により腰痛の有無，腰椎X線撮影により腰椎変性所見を評価し，それらの関連性を検討した．その結果，腰痛の有無との間に有意な関連が認められたのは腰椎前弯角とすべりの有無であったが，相関関係は小さかった．すなわち，腰痛の有無に影響を及ぼす因子として腰椎変性の関与は小さい．この事実は，器質的要因以外の因子が腰痛に関与している可能性を示唆している．

　The purpose of this study is to determine whether correlations between low back pain (LBP) in the elderly and radiographic findings of lumbar degeneration. Among those who underwent an annual community health examination in 2002, the 413 subjects (175 men, 238 women；age 65-94, mean age 74 years) who were age 65 years or older were interviewed about the presence of LBP and underwent x-ray studies to assess degeneration of the lumbar disc, lordosis, spondylolisthesis, calcification of the abdominal aorta and vertebral collapse. We assessed LBP and the x-ray findings for correlations by multiple regression analysis. The results showed that only radiographic findings that were significantly correlated with the presence of LBP were the angle of lumbar lordosis and the presence of spondylolisthesis. However, combination of all 5 radiographic findings of lumbar degeneration could predicted the presence of LBP in only 3.5％. Thus, the contribution of radiographic findings of lumbar degeneration to predicting the presence of LBP appears to be trivial.