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Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction


Urquhart, DM and Kurniadi, I and Triangto, K and Wang, Y and Wluka, AE and O'Sullivan, R and Jones, G and Cicuttini, FM, Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction, Spine, 39, (16) pp. E962 - E966. ISSN 0362-2436 (2014) [Refereed Article]

Copyright Statement

Copyright 2014 Lippincott Williams & Wilkins

DOI: doi:10.1097/BRS.0000000000000411


STUDY DESIGN: Cross-sectional, community-based study. OBJECTIVE: To investigate the relationships between obesity, disc height, and low back pain in the lumbosacral spine. SUMMARY OF BACKGROUND DATA: Although obesity is a recognized risk factor for low back pain, our understanding of the mechanisms for this is limited. The evidence for an association between obesity and spinal structural changes is also conflicting. METHODS: Seventy-two participants from a community-based study of musculoskeletal health underwent magnetic resonance imaging from the T12 vertebral body to the sacrum. Disc height was measured from L1-L2 to L5-S1. Body mass index was measured and low back pain in the previous 2 weeks was assessed. RESULTS: The mean and total lumbar disc heights were reduced in obese individuals compared with nonobese individuals (mean height (standard error):1.04 (0.03) cm vs. 1.14 (0.02) cm, P = 0.01; total height (standard error):4.16 (0.11) cm vs. 4.57 (0.10) cm, P = 0.01), after adjusting for age, sex, and height. Although obesity was associated with reduced disc heights at the L1-L2 and L3-L4 levels, there were no significant relationship at the lumbosacral junction (mean difference (95% confidence interval [CI]):0.10 (-0.14 to 0.16) cm, P = 0.89). Both mean and total lumbar disc heights were negatively associated with recent pain after adjusting for age, sex, and height (mean height: mean difference (95% CI):0.09 (0.02-0.17) cm, P = 0.02; total height: mean difference (95% CI): 0.37 (0.07-0.66) cm, P = 0.02). However, these relationships were no longer significant when we also adjusted for weight (mean height; mean difference (95% CI):0.07(-0.009 to 0.15) cm, P = 0.08; total height: mean difference (95% CI):0.28 (-0.04 to 0.60) cm, P = 0.08). There were no significant relationships between disc height and recent pain at the lumbosacral junction. CONCLUSION: Obesity was associated with reduced disc height in the lumbar spine, but not at the lumbosacral junction, suggesting these joints may have different risk factors. There was also evidence for an inter-relationship between obesity, lumbar disc height, and recent pain, suggesting that structural changes have a role in back pain and may in part explain the association between obesity and back pain.Level of Evidence: 3.

Item Details

Item Type:Refereed Article
Keywords:obesity, disc height, low back pain, lumbar spine, lumbosacral, structure, magnetic resonance imaging
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:93261
Year Published:2014
Web of Science® Times Cited:18
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-07-23
Last Modified:2017-11-02

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