Prevalence,Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis

Chronic low back pain (CLBP) is common among older adults. This systematic review aimed to summarize: (1) the prevalence and incidence of CLBP in older adults, and (2) demographic, psychological, and clinical factors positively/negatively associated with prevalence/incidence of CLBP among older adults. Four databases were searched to identify relevant publications. Ten studies (31,080 older adults) were included after being screened by 5 independent reviewers using predetermined criteria. The methodological quality of these studies was evaluated by standardized tools. The quality of evidence for all factors were appraised by modified GRADE for cohort studies. Twenty-eight and 1 factors were associated with a higher prevalence and a lower 5-year cumulative incidence of CLBP, respectively. No prognostic factor was identified. There was very limited to limited evidence that females, obesity, anxiety, depression, mental disorders, self-expectation of recovery, self-perceived health status, lifestyle (smoking, daily fluoride consumption), previous falls or lower body injury, retirement/disability due to ill health, family history of body pain, comorbidity (knee osteoarthritis, or chronic obstructive pulmonary disease with/without hypertension), weak abdominal muscles, leg pain, leg pain intensity, widespread pain, pain interference on functioning, use of pain medication, occupational exposure (driving for >20 years, or jobs involving bending/twisting for >10 years), disc space narrowing and severe facet osteoarthritis were significantly related to a higher prevalence of CLBP in older adults. However, very limited evidence suggested that intermediate level of leisure-time physical activity was associated with a lower prevalence of CLBP in older adults. Given the aging population and limited information regarding risk factors for CLBP in older adults, future high-quality prospective studies should identify relevant risk factors to help develop proper preventive and treatment strategies.PerspectiveDespite the high prevalence of non-specific chronic low back pain among older adults, there is only very limited to limited evidence regarding factors associated with a higher prevalence of chronic low back pain in this population. Given the aging population, high-quality prospective studies are warranted to address this gap.     

局部生物力学因素在L5/S1椎间盘突出症发病中的作用

背景：近年来,有关生物力学因素与腰背痛关系的报道大多集中在腰椎整体生物力学与腰背痛的研究上,而针对局部生物力学特点与单纯腰椎间盘突出的研究则较少。目的：探讨局部生物力学因素在L5/S1椎间盘突出症发病中的作用。方法：共纳入对象124例,包括椎间盘突出症组和对照组,62例/组。椎间盘突出症组为2008-06/2009-07于青岛大学医学院附属医院诊断明确并行手术治疗的L5/S1椎间盘突出症患者;对照组为健康体检人员。在腰椎正侧位X射线片上测量和观察各组L5椎体相对深度、腰骶移行椎、L5/S1椎间盘相对高度、腰骶角、骶骨水平角和骶骨垂直角的变化。结果与结论：与对照组比较,椎间盘突出症组L5椎体相对深度明显增加（P〈0.01）,椎间盘突出症组腰骶移行椎数目明显降低（P〈0.01）,说明相对位置较深的L5椎体及腰骶移形椎可能对L5/S1椎间盘具有保护作用,可降低L5/S1椎间盘突出症的发生率。椎间盘突出症组腰骶角和骶骨水平角明显减小（P〈0.01）;但L5/S1骶骨垂直角和椎间盘相对高度在椎间盘突出症组与对照组之间差别无显著性意义（P〉0.05）,可见,L5/S1椎间盘相对高度、腰骶角、骶骨水平角和骶骨垂直角与椎间盘突出的关系仍不明确,需进一步探讨。     

Relationships between forward head posture and lumbopelvic sagittal alignment in older adults with chronic low back pain

BackgroundAbnormal posture creates abnormal stress and strain in many spinal structures which are considered predisposing factors for chronic mechanical low back pain.PurposeTo examine the relationships among pain intensity, forward head posture (decreased craniovertebral angle) and lumbopelvic sagittal alignment (pelvic incidence, pelvic tilt, sacral slope, and lumbar lordosis) in chronic mechanical low back pain patients.MethodsA cross-section correlational study was conducted on one hundred patients. A numerical-pain-rating scale was used to determine pain intensity. Standardized standing lateral radiographs were analyzed to measure the spinopelvic angles. Reported data were analyzed using correlation coefficients, and regression analyses.ResultsLumbar lordosis had very strong positive correlations with each pain intensity and sacral slope. Pain intensity had a strong positive correlation with sacral slope. Moderate positive correlations highlighted between pelvic tilt and craniovertebral angle. Moreover, the pelvic incidence had weak positive correlations with each sacral slope and pelvic tilt. Negative correlations were strong between pelvic tilt and each of pain intensity, lumbar lordosis and sacral slope. Craniovertebral angle had moderate negative correlations with each of pain, lumbar lordosis, and sacral slope. However, the pelvic incidence had no relations with pain, craniovertebral angle lumbar lordosis. Overall, an association of demographic data and measured variables had a significant effect on the pain multi-regression equation prediction model. They accounted for 76.60% of the variation in pain.ConclusionAbnormal spinopelvic posture relates to chronic mechanical low back pain. There are significant associations among pain intensity, FHP and lumbopelvic sagittal alignment in chronic mechanical low back pain patients.     

Computational modeling of lumbar disc degeneration before and after spinal fusion

BackgroundAdvancing age and degeneration frequently lead to low back pain, which is the most prevalent musculoskeletal disorder worldwide. Degenerative changes in intervertebral discs and musculo-ligamentous incapacity to compensate sagittal imbalance are typically amongst the sources of instability, with spinal fusion techniques being the main treatment options to relieve pain. The aims of this work were to: (i) assess the link between ligament degeneration and spinal instability by determining the role of each ligament per movement, (ii) evaluate the impact of disc height reduction in degenerative changes, and (iii) unveil the most advantageous type of posterior fixation in Oblique Lumbar Interbody Fusion to prevent adjacent disc degeneration.MethodsTwo L3-L5 finite element models were developed, being the first in healthy condition and the second having reduced L4-L5 height. Different degrees of degeneration were tested, combined with different fixation configurations for Oblique Lumbar Interbody Fusion.FindingsFacet capsular ligament and anterior longitudinal ligament were the most influential ligaments for spinal stability, particularly with increasing degeneration and disc height reduction. Pre-existent degeneration had lower influence than the fusion procedure for the risk of adjacent disc degeneration, being the highest stability and minimal degeneration achieved with bilateral fixation. Right unilateral fixation was more suited to reduce disc stress than left unilateral fixation.InterpretationBilateral fixation is the best option to stabilize the spinal segment, but unilateral right fixation may suffice. This has direct implications for clinical practice, and the extension to a population-based study will allow for more efficient fusion surgeries.     

Sagittal plane motion in the human lumbar spine: comparison of the in vitro quasistatic neutral zone and dynamic motion parameters

BACKGROUND: Disabling low back pain is often attributed to clinical instability but defining instability is problematic. The most common parameter used to characterize instability in the lab is the neutral zone which is measured with a quasi-static technique. But, it cannot be measured from continuous motion data. Our goal was to describe the relationship between the quasi-static neutral zone and dynamic motion parameters that might reflect laxity about the neutral position. We also sought to determine if dynamic parameters were correlated with disc degeneration. METHODS: Fifteen cadaveric lumbar motion segments were tested with both quasi-static and dynamic (continuous load) methods. Quasi-static range of motion and neutral zone were compared with dynamic range of motion, hysteresis loop width, and two parameters derived from the hysteresis data: transitional zone size and slope. Degeneration was graded macroscopically. FINDINGS: Neutral zone size was moderately correlated with hysteresis loop width (r=0.69) and strongly correlated with the transitional zone slope (r=-0.80). Degenerative grade had a significant effect on dynamic range of motion and transitional zone size and slope with differences found between grade 1 (normal) discs and higher grades. Only transitional zone slope was different between grades 1 and 2. INTERPRETATION: The transitional zone slope (representing the neutral region stiffness) had the strongest correlation with neutral zone and could best detect lower grades of degeneration. The transitional zone slope might be a useful parameter in dynamic studies investigating the association between degeneration and motion segment behavior.     

Get Your Head in the Game: A Replicated Single-Case Experimental Design Evaluating the Effect of a Novel Virtual Reality Intervention in People With Chronic Low Back Pain

Chronic low back pain (CLBP) is a leading cause of disability worldwide. Contemporary treatment of CLBP is suboptimal, with small-moderate effect sizes and high relapse rates. Virtual reality (VR) is an increasingly accessible technology that can improve adherence to exercise programs through gamification. Using VR to facilitate exercise adherence and enjoyment may improve the clinical outcomes. This study aimed to evaluate the effects of a gamified VR graded activity intervention in people with CLBP, using commercially available and bespoke VR programs. A sequentially replicated, multiple-baseline, randomized AB single-case experimental design was undertaken in 10 people with CLBP. Outcomes were assessed daily and included pain intensity (primary) and pain catastrophizing, pain-related fear, and anxiety/worry (secondary). The effect of the intervention on the primary outcome was evaluated using a multilevel-model, nonparametric randomization test. The VR graded activity intervention resulted in a significant reduction in pain intensity (effect estimate = −1.0, standard error = .27, P < .0011) with 4 participants achieving ≥30% pain reduction (minimum important change). There was a significant effect of the intervention on pain catastrophizing but not pain-related fear or anxiety/worry measures. These findings provide preliminary support for a VR graded activity program to reduce pain in people with CLBP.PerspectiveThis novel, VR graded activity intervention reduced pain intensity and catastrophizing in people with CLBP. The intervention also had high adherence and enjoyment. Given that this intervention involved 2 freely available VR programs, it can be easily translated into clinical practice.     

Heritability of low back pain and the role of disc degeneration

Twin studies suggest that both disc degeneration and back pain have a genetic component. We were interested in estimating the heritability of low back pain in men and examining whether genetic influences on back pain are mediated through genetic influences on disc degeneration. Thus, we conducted a classic twin study with multivariate quantitative genetic models to estimate the degree to which genetic (or environmental) effects on back pain were correlated with genetic (or environmental) effects on disc degeneration. Subjects included 147 monozygotic and 153 dizygotic male twin pairs (N=600 subjects) from the population-based Finnish Twin Cohort. All subjects underwent lumbar magnetic resonance imaging and completed an extensive interview, including back pain history and exposure to suspected risk factors. Disc height narrowing was the degenerative finding most associated with pain history, and was used to index disc degeneration in the models. Statistically significant genetic correlations were found for disc height narrowing and different definitions of back pain, such as duration of the worst back pain episode (r(g)=0.46) and hospitalization for back problems (r(g)=0.49), as well as disability in the previous year from back pain (r(g)=0.33). The heritability estimates for these back pain variables ranged from 30% to 46%. There also were statistically significant, but weaker, environmental correlations for disc height narrowing with back symptoms over the prior year. A substantial minority of the genetic influences on pain was due to the same genetic influences affecting disc degeneration. This suggests that disc degeneration is one pathway through which genes influence back pain.     

Foraminal encroachment syndrome in true lumbosacral spondylolisthesis: a preliminary report

The source of pain in isthmic spondylolisthesis is uncertain. Some authors believe that spondylolysis and/or spondylolisthesis is not a predisposing factor to low back pain and that the mere presence of isthmic spondylolisthesis may, indeed, not be the cause of low back pain in the patient. This study explores a possible source of biomechanical dysfunction as an origin of pain in isthmic spondylolisthesis. One hundred and twenty lumbar intervertebral disc angles were measured, 60 of which had spondylolisthesis and the remaining 60 without spondylolisthesis for comparison of the effect that spondylolisthesis has on intervertebral disc angulation of the lumbar spine. The results reveal that the L4-L5 joint has the greatest biomechanical stress placed upon it by virtue that it had the highest intervertebral disc angulation when the component of spondylolisthesis was a factor at L5-S1. Therefore, due to increased intervertebral disc angles at L4-L5, a biomechanical stressing and resulting hyperextension of the facet articulation at L4-L5 may represent a source of symptomatology in isthmic spondylolisthesis of L5-S1.     

腰骶椎矢状位形态学改变与椎间盘退变的MRI评价

背景：目前关于椎间盘退变在MRI上的影像学表现及其与下腰痛的关系报道甚多,但腰骶椎矢状位形态学改变与椎间盘退变程度的关系国内尚未见相关报道。目的：观察下腰痛患者腰骶椎矢状位形态学改变与椎间盘退变的关系,并探讨其临床意义。方法：对主诉下腰痛来安徽医科大学第一附属医院门诊就诊并行MRI检查的患者做回顾性分析,选择年龄20～30岁的女性患者167例,在MRI正中矢状面的T2W1图像上观察椎间盘的信号改变及退变程度,评价退变分级,测量每个患者的腰椎前凸角,骶骨平台角及骶椎后凸角度。结果与结论：椎间盘退变组与无椎间退变组腰椎前凸角分别为（24.31±3.48）°和（26.29±3.74）°,差异有显著性意义（P=0.001）;骶骨平台角分别为（102.97±5.58）°和（100.70±3.26）°,差异有显著性意义（P=0.002）;骶骨后凸角分别为（163.45±7.03）°和（167.24±6.71）°,差异有显著性意义（P=0.001）。提示腰椎前凸角、骶骨后凸角、骶骨平台角是评价椎间盘退变程度的形态学参数,腰椎前凸角和骶骨后凸角随椎间盘退变加重而减小,骶骨平台角随椎间盘退变加重而增大。     

Anterior lumbar interbody fusion--advances in spinal fusion technology

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AS MUCH AS 80% OF THE US POPULATION will be affected by back pain at some time during their lives. Some of the most common disorders are herniated disc, degenerative disc disease, degenerative spondylolisthesis, spinal stenosis, and revision of previously failed low back surgery.

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IF CONSERVATIVE TREATMENT for back pain fails, spinal fusion may be performed. Anterior lumbar interbody fusion effectively manages degenerative joint disease, instability, and spondylolisthesis.

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NURSES WHO PROVIDE CARE for patients undergoing this procedure help ensure patient safety and promote positive outcomes. AORN J 82 (November 2005) 817-823.

     

The impact of chronic low back pain on older adults: a comparative study of patients and controls

Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g., medical illnesses, sleep disturbance, mobility difficulty), the unique impact of CLBP is unknown. We conducted this research to identify the multidimensional factors that distinguish independent community dwelling older adults with CLBP from those that are pain-free. Three hundred twenty cognitively intact participants (162 with moderate pain for 3 months, and 158 pain-free) underwent comprehensive assessment of pain severity, medical comorbidity (illnesses, body mass index, medications), severity of degenerative disc and facet disease, lumbar flexion, psychological constructs (self-efficacy, mood, overall mental health), and self-reported as well as performance-based physical function. Significant differences were ascertained for all 22 measures. Discriminant function analysis revealed that eight measures uniquely maximized the separation between the two groups (self-reported function with the Functional Status Index and the SF-36, performance-based function with repetitive trunk rotation and functional reach, mood with the Geriatric Depression Scale, comorbidity with the Cumulative Illness Rating Scale and BMI, and severity of degenerative disc disease). These results should help to guide investigators that perform studies of CLBP in older adults and practitioners that want an easily adaptable battery for use in clinical settings.     

No association between level of vitamin D and chronic low back pain in Swedish primary care: a cross-sectional case-control study

Objective: Assessment of vitamin D levels and deficiency status in individuals with chronic low back pain (CLBP) in a Swedish general population, compared with controls matched for sex and age.

Design: Cross-sectional case-control study.

Setting: Primary care, southern Sweden.

Subjects: Participants (n?=?44) with self-reported low back pain for at least 3 months and individually sex- and age-matched controls without a chronic pain condition (n?=?44), recruited from the general population by random letter of invitation.

Main outcome measure: Association between vitamin D level and CLBP when adjusting for possible confounders in a multivariate forward conditional logistic regression model.

Results: Mean S-25-hydroxyvitamin D levels were 81 and 80?nmol/L in the CLBP and control group, respectively. The prevalence of vitamin D deficiency was low and similar in the CLBP group and the control group. Vitamin D level was not associated with CLBP when potential confounders were taken into account.

Conclusions: No difference in vitamin D levels between participants with CLBP and matched controls could be demonstrated in the present sample. Assessment of vitamin D level and deficiency status may be of questionable value in the management of CLBP in primary care settings at similar latitudes, unless there are additional risk factors for deficiency or specific indicators of osteomalacia.

• Key Points

• Vitamin D deficiency is common and reported in many chronic pain conditions, including chronic low back pain (CLBP), but evidence for an association and causality is insufficient.

• The present study found no association between vitamin D levels and CLBP in a case-control sample of 44?+?44 individuals from the Swedish general population.

• Prevalence of vitamin D deficiency was low and comparable in individuals with CLBP and controls without chronic pain, matched for sex and age.

• Assessment of vitamin D status, for the purpose of finding and treating an underlying cause of pain, may be of limited value in the management of CLBP in primary care settings at similar latitudes.

     

软骨终板形态与椎间盘退变的相关性

背景:以往研究证明多种内环境因素共同作用引发椎间盘退变,最重要的机制为椎间盘软骨终板的退变。目的:分析椎间盘退变与终板形态的关系。方法:回顾性分析62例因椎间盘源性慢性下腰痛和79例因髓核脱出致神经根性症状患者的腰椎MRI正中矢状位图像资料。根据腰椎MRI正中矢状位T1W1图像确定终板形态,T2W1图像确定椎间盘退变程度分级。结果与结论:平坦型和不规则型终板最常见于椎间盘退变人群下腰椎,L5/S1平坦型最多见。髓核脱出组与椎间盘源性慢性下腰痛组中凹陷型终板椎间盘退变程度均较平坦型、不规则型低,平坦型终板椎间盘退变程度较不规则型低(P<0.01)。两组间凹陷型与不规则型终板椎间盘退变程度差异无显著性意义,髓核脱出组平坦型椎间盘退变程度较椎间盘源性慢性下腰痛组高(P<0.05)。提示随着椎间盘退变程度的加重,软骨终板形态有由凹陷型向平坦型、不规则型依次转变的趋势。     

Efficacy of percutaneous endoscopic lumbar discectomy for pediatric lumbar disc herniation and degeneration on magnetic resonance imaging: case series and literature review

ObjectivePediatric lumbar disc herniation (LDH), although uncommon, causes significant pain, discomfort, and sometimes disability. We examined the efficacy of percutaneous endoscopic lumbar discectomy (PELD) for pediatric LDH and the degree of lumbar disc degeneration at 1 year after PELD.MethodsWe retrospectively reviewed the data of pediatric patients with LDH who underwent PELD from December 2007 to July 2018. The patients’ symptoms, physical examination findings, clinical images, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and perioperative results (blood loss, length of hospital stay, and complications) were obtained from the medical records. Lumbar disc degeneration was graded using the modified Pfirrmann grading system at the 1-year postoperative magnetic resonance imaging (MRI) examination.ResultsSix boys and four girls who underwent PELD were evaluated. The patients’ mean age was 15.6 years (range, 13–17 years). The mean VAS score for low back pain, mean VAS score for lower limb pain, and mean ODI preoperatively and 1 year postoperatively were 6.2 and 0.3, 6.9 and 0.5, and 20 and 0.1, respectively. MRI showed significant disc degeneration after PELD.ConclusionsTreating pediatric LDH with PELD is safe and effective. It relieves pain and reduces disability. However, lumbar disc degeneration still occurs.     

影像学分析髂腰韧带与L5/S1椎间盘突出及L5滑脱的力学强度关系

背景：国外与国内研究报道的髂腰韧带形态学特点有很大争议,有关国人髂腰韧带解剖学结构和生物力学特性的报道并不多见,尚未见全面详尽的统计资料。目的：探讨国人L5/S1椎间盘突出及L5滑脱与髂腰韧带的关系。方法：纳入2013年苏州大学附属第一医院正常体检者28例、L5/S1椎间盘突出患者26例及L5滑脱患者26例,正常组男9例、女19例;单纯L5/S1椎间盘突出组男14例、女12例;单纯L5滑脱组男7例、女19例;其中峡部崩裂性滑脱13例、退变性滑脱13例;Ⅰ度滑脱24例、Ⅱ度滑脱2例。在腰椎正位片上测量并计算出各病例L5横突的相对宽度（RT值）,并进行对比分析。结果与结论：正常组、单纯 L5/S1椎间盘突出组、单纯 L5滑脱组年龄、性别差异无显著性意义。正常组 RT值大于单纯 L5/S1椎间盘突出组、单纯 L5滑脱组（P 均=0.000）;单纯 L5/S1椎间盘突出组大于单纯 L5滑脱组（P=0.000）。男性、女性患者RT值差异无显著性意义;患者左侧、右侧RT值差异无显著性意义;在L5滑脱的病例中,退变性滑脱患者 RT 值小于峡部裂性滑脱患者（P=0.004）。提示正常人髂腰韧带强度高于 L5/S1椎间盘突出及 L5滑脱患者,L5/S1椎间盘突出患者高于 L5滑脱患者;峡部裂性滑脱患者髂腰韧带强度高于退变性滑脱患者。髂腰韧带力学强度可能与L5/S1椎间盘突出及L5滑脱病变有关。     

Computed tomography diagnostic of the intervertebral disc degeneration and degenerative changes of the lumbo-sacral spine

Background. The aim of the work is problem of computed tomography diagnostic of the intervertebral disc degeneration and degenerative changes of the lumbo-sacral spine.
Authors present result of computed tomography examinations performed in 60 patients at the age from 18 to 69 years, suffering from chronic low back pain for 6 months at least.
Material and methods. Degenerative changes of the vertebra-disc junction on the levels of L3-L4, L4-L5 and L5-S1 were evaluated. The analysis of intervertebral disc changes and osteophytes presence on all of the investigated levels was chose as the assessment criterion.
Results. The pathological changes of the vertebra-disc junction on L5-S1, L4-L5 and L3-L4 levels were stated in 58 (96.6%), 55 (91.6%) and 47 (78.8%) patients, whereas the degeneration of the intervertebral disc was diagnosed in 50, 45 and 15 cases, respectively. Moreover, the vacuum phenomenon was present in connection with the degeneration of the intervertebral disc on L5-S1, L5-L4, L3-L4 levels in 29, 11 and 1 cases, respectively. The osteophytes' presence, as a single proof of the degenerative changes was diagnosed in 8 patients on L5-S1 level, whereas on L4-L5 level in 10 patients. In 32 cases osteophytes were localised on L3-L4 level.
Conclusions. In conclusion, the differences in morphology of the pathological changes are the result of different loading and various mechanisms generating these changes on particular levels.     

Differences of lumbosacral kinematics between degenerative and induced spondylolisthetic spine

OBJECTIVE: To investigate the differences of lumbosacral kinematics between degenerative and induced spondylolisthetic subjects. DESIGN: Translations and angulations of spondylolisthetic spine from L1-L2 to L5-S1 were documented by taking X-ray films at flexion, standing and extension positions. BACKGROUND: The unstable mechanism of spondylolisthesis leads to lower back pain. It is important to determine the kinematics and the process of spondylolisthesis. METHODS: Nineteen subjects with spondylolisthesis participated in this research, seven subjects with diagnosis of degenerative and 12 with induced spondylolisthesis, were taken lateral radiographs at three positions including flexion, standing and extension. RESULTS: The differences of angulation among three positions (flexion, standing, and extension) at different levels were statistically significant (P<0.05) in both spondylolisthetic groups. The differences of translation among three different positions in induced spondylolisthetic group had a statistical significance (P<0.05) except at the level of L5-S1 (P>0.05). CONCLUSIONS: Segmental total translation and angulation at each level of induced spondylolisthetic spine were greater than those of degenerative spondylolisthetic spine except L5-S1 level, which illustrated the evolution of spondylolisthesis from unstable to less unstable. RELEVANCE: The results showed induced spondylolisthesis may link to degenerative spondylolisthesis. It provided essential knowledge to detect the evolution of degenerative spondylolisthesis clinically earlier.     

Computed tomorgaphy diagnostic of lumbar spondylolysis

Background. Low back pain is the main reason of reduction in physical activity. The aim of this study was to determine lumbar spine changes in patients with spondylolysis using computed tomography (CT) completed with multiplanar (MPR) and three-dimensional (3D) reconstructions. Material and methods. The investigation was performed on 35 patients at the age from 13 to 79 years suffering from chronic low back pain with recognised lumbar spondylolysis. All these patients were subjected to anteroposterior and lateral radiography, and computed tomography (CT) and CD reconstructions Results. Spondylolysthesis was diagnosed as grade I in thirty patients, grade II in two patients and grade IV in other two patients. No signs of spondylolysthesis observed in three cases. The deformations of intervertebral foramina were confirmed in 26 patients (74.29%) and their craniocaudal narrowing was present in 22 cases (62.86%). The osteophytes around fissure margin of lumbar spondylolysis were found in 20 patients (57.14%). The herniation of nucleus pulposus of intervertebral disc was shown in 11 patients (31.43%). The degenerative changes of L4-L5 and L5-S1 intervertebral joints were present in 9 cases (25.71%), whereas the spina bifida of S1 vertebra was stated in four patients (11.43%). Conclusions. 1. High percentage of deformations and narrowing of the intervertebral foramen and the osteophytes around fissure margin of lumbar spondylolysis, and the intervertebral disc herniation were diagnosed in patients with low back pain and spondylolysis using computed tomography completed with MPR and 3D reconstructions. 2. The axial scans completed with multiplanar and three-dimensional reconstructions are very usefull in diagnostic of spondylolysis and spondylolisthesis.