A comparative roentgenographic analysis of the lumbar spine in male army recruits with and without lower back pain

Aim: To determine whether there is an association between lumbar spine radiographic findings and reported current and/or past lower back pain (LBP). Materials and Methods: Four hundred and sixty-four age-matched (mean age 18 years ± 2 months) consecutive male army recruits were examined. Half of them had a history of episodes of LBP. An orthopaedic evaluation (including radiographs of the lumbar spine) is part of the routine medical examination for all military recruits. Two senior orthopaedic surgeons and one radiologist who performed the morphological measurements assessed the radiographs. Results: We found an increased frequency of right-sided scoliosis, lumbar lordosis, sacral lumbarization, wedge vertebra, bilateral spondylolysis of L5 and/or a sagittal diameter of less than 12 mm among the recruits with LBP. No such association was found with spina bifida, left-sided scoliosis, hemi-lumbarization, sacralization and hemi-sacralization, Schmorl's nodules or mild degenerative changes. Conclusion: Given that radiographic screening shows that LBP is more common in those with spinal deformity it may be a reasonable means of predicting which individuals are more likely to develop LBP.