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  • Title: Novel elemental grading system for radiographic lumbar spondylosis in a population based-cohort study of a Japanese mountain village.
    Author: Yamada J, Akeda K, Takegami N, Fujiwara T, Nishimura A, Sudo A.
    Journal: PLoS One; 2022; 17(6):e0270282. PubMed ID: 35763521.
    Abstract:
    PURPOSE: Lumbar radiography is a primary screening tool for lumbar spondylosis (LS). Kellgren-Lawrence (KL) classification is widely used to evaluate LS; however, it cannot individually evaluate each radiographic feature. The purpose of this study was to 1) evaluate radiographic LS using a novel elemental grading system and 2) investigate the relationship between the grades of radiographic LS and low back pain (LBP) in a population-based cohort study. METHODS: A total of 260 (75 men, 185 women; mean age, 71.5 ± 8.7 years) participants were included in this study. Participants were divided into two groups according to the presence of LBP (LBP- and LBP+ groups). Radiographic features, including osteophyte (OP), disc height narrowing (DHN), vertebral sclerosis (VS), and spondylolisthesis (SL), were classified between grades of 0-2 grades according to the extent of radiographic changes. The sum of grades at each intervertebral level was designated as the intervertebral grade (IG). RESULTS: Intra- and inter-observer reliability (kappa coefficient) of OP, DHN, VS, and SL were 0.82-0.92. OP, DHN, VS, and IG grades were significantly higher in the LBP+ group than in the LBP- group. There were no significant differences in KL grades between the LBP- and LBP+ groups. Logistic regression analysis demonstrated that VS grade was a significant independent factor associated with LBP. CONCLUSION: The novel elemental grading system of LS would reflect LBP more accurately than the KL classification by individually evaluating each radiographic feature.
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