Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Chronic low back pain and its association with lumbar vertebrae and intervertebral disc changes in adults. A case control study(Wiley, 2018) Karunanayake, A.L.; Pathmeswaran, A.; Wijayaratne, L.S.AIM: This study was done to determine the association between chronic low back pain and vertebral fractures, intervertebral disc space (IDS) narrowing, vertebral osteophytes and spondylolisthesis among adults. METHOD: This case control study was done in Sri Lanka. Cases were patients with low back pain and controls were without low back pain. Postero-anterior and lateral radiographs of lumbar sacral spine of both groups were studied. To detect vertebral fractures in fourth and fifth lumbar vertebrae, anterior and posterior heights of vertebrae were measured using a Vernier caliper and antero-posterior ratio (A/P) was calculated. Having an A/P ratio value of < 0.89 was considered as a vertebral fracture. Presence of disc space narrowing, vertebral osteophytes and spondylolisthesis was assessed by two radiologists working independently. Bivariate and logistic regression analysis was done to find associations. RESULTS: There were 140 cases and 140 controls. Mean (SD) age for cases was 51.6 (17) years. Mean (SD) age for controls was 50 (15) years. Females made up 62% of cases and controls. Fifth lumbar vertebral fracture (odds ratio [OR] = 10.2; P = 0.001), fourth lumbar vertebral fracture (OR = 2.5; P = 0.017) and IDS narrowing (OR = 4.15, P = 0.009) had a significant association with low back pain and vertebral osteophytes and spondylolisthesis did not have a significant association with low back pain. CONCLUSION: Only vertebral fractures and IDS narrowing had a significant association with chronic low back pain.Item Radiological changes of spine in patients with chronic low back ache(Department of Family Medicine, Aga Khan University Pakistan, 2007) Karunanayake, A.L.; Pathmeswaran, A.; Wijayaratne, L.S.OBJECTIVE: To determine the association between causes such as disc space narrowing, vertebral osteophytes and spondylolisthesis with chronic low backache among Sri Lankan adults. METHODOLOGY: A case control study was done at the Teaching hospital Ragama and Rehabilitation hospital Ragama Sri Lanka. Postero- anterior and lateral radiographs of the lumbo- sacral spine of a hundred and thirty cases and a hundred and thirty three controls were studied. The cases and controls were matched for age and sex. All radiographs were read by two radiologists working independently for the presence of verebral osteophytes, spondylolisthesis and disc space narrowing. The results were analysed by applying chi squared test for bivariate associations and logistic regression for multivariate associations. RESULTS: The age range of the study subjects was 18-82 years. Mean (SD) age for cases was 49.3 years (15 years); Mean (SD) age for controls was 51.4 years (17 years). There were 81 (62.3%) females with low backache and 82 (61.7%) females without low backache. Disc space narrowing was present in 15% of cases and 2% of controls. A person with disc space narrowing had a 7 times greater chance of developing low backache compared to a person without disc space narrowing (OR = 6.8, P= 0.008). Vertebral osteophytes were present in 72% of cases and 64% of controls. Spondylolisthesis was present in 8% of cases and 7% of controls. Vertebral osteophytes and spondylolisthesis did not have a significant association with low backache. Conclusion: Among the radiological features of the lumbar spine, disc space narrowing was the only feature with a significant association with low backache.