Incidence of spinal instability among patients with discogenic low back pain with different backgrounds.
Makoto Takahashi, Koji Iwamoto, Motoki Kuzuyama and 4 others
PMID 34393371WHAT IT FOUND
More than half of patients with discogenic low back pain showed spinal instability on X-ray.
This instability was not linked to age, gender, sports activity, or occupation. These findings describe who has instability but do not prove that instability causes pain or that specific treatments work.
Key findings
0157% of patients had lumbar spinal instability, defined as segmental angulation >10° or sagittal translation >3mm.
02There were no significant differences in age, gender, sports activity, or occupation between the instability and stability groups.
STILL TO COME
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What it does not show
The study is retrospective and cross-sectional, so it cannot determine if instability causes pain or if pain leads to instability. The definition of instability (10° angulation or 3mm translation) is based on previous literature but lacks consensus for nonspecific discogenic pain. The study did not measure pain intensity or functional status, so it is unclear if the 57% with instability were more symptomatic than the 43% without. The sample size is relatively small (65 patients) and from a single clinic, limiting generalizability. The authors suggest stability training in the conclusion, but the study did not test any treatment, so this is an opinion, not a finding.
Declared interests
The authors declare no conflicts of interest. There was no funding for this study.
The easy way to misread this
Do not assume that spinal instability is the cause of the patient's pain or that treating it will resolve symptoms. This study only reports how many patients had instability; it did not compare pain levels between groups or test any intervention. The authors' suggestion of stability training is an expert opinion, not a result of this research.