Nursamsu Djais, Handono Kalim
Objectives: To test the hypothesis that radiography of the lumbar spine in patients with simple acute low back pain (LBP) is not associated with improved patient outcomes. Methods: A small randomized unblinded controlled trial in patients with simple acute low back pain with duration of less than 12 weeks. This study was held in the outpatient Department of Rheumatology, Dr Saiful Anwar Hospital from May to September 2003. Intervention was usual care with lumbar spine radiography versus usual care without lumbar spine radiography. The outcome measures are Roland score, visual analogue scale for pain, EuroQol-5 dimensions including the health status scale, at 3-weeks after treatment. Statistical analysis with Mann-Whitney U-test, χ2 test or Fisher's exact test with odds ratio. Analysis were performed using SPSS V. 10.0 for Windows. Results: During the 5 months of the study, 101 patients with LBP fulfilled the criteria of study presented at the Dr Saiful Anwar Hospital. Of the 101 patients, 75.2% patients completed the study. The intervention group significantly had a lower overall health status scale [70 (50, 80) vs. (80 (70, 90); Z =-2.28; P = 0.02] and slightly higher Roland and pain scores, [6.5 (2, 10) vs. 4.5 (2, 7); Z = -1.17; P = 0.25] and [4 (2, 6) vs. 3 (2, 5); Z = -1.82; P = 0.07], respectively. Conclusions: Radiography of the lumbar spine in patients with simple acute low back pain is not associated with improved patient functioning or severity of pain. Indeed, the overall health status of those who had a lumbar spine X-ray appeared to be worse than those who did not. © Asia Pacific League of Associations for Rheumatology.
Internal Medicine Department, Medical Faculty of Brawijaya University, Dr. Saiful Anwar Hospital, Malang, Indonesia
