Intoduction: Chronic low back pain (LBP) is a patologic condition caused by lumbar degeneration. It has been proven, that atherosclerosis factors (by atherom plaque formation on abdominal aortic wall and aa. lumbalis/sacral-media stenosis) has a role in this degeneration process. Aim: To see the corelation of ankle-brachial index (ABI)—as surrogate marker of atherosclerosis—and clinical manifestation of chronic LBP. Method: This analitic cross-sectional study used consecutive sampling on patients coming to Neurology Clinic of Cipto Mangunkusumo Hospital, Jakarta. Subject criteria was 30-49 years old person, range of body-mass-index 18.5-29.9 kg/m2, without any biomechanical risk factors against lumbar structures. Chronic LBP was diagnosed by interview and physical examination, confirmed by electrophysiologic examination. The clinical appearance was classified based on pain type, neurologic deficits (involvement of L3, L4, L5, and S1 nerve roots), and Lasegue (straight-leg-raising) sign. ABI was measured using vascular doppler ultrasound. Result: Total subject was 62, with each group (non-LBP and LBP group) consist of 31 subjects. There was no demographic differences between non-LBP and LBP groups. This study found difference in ABI mean beetwen those groups, whereas ABI in non-LBP group (0.987) was significantly lower compared to ABI in LBP group (1.098), with 0.110 ABI difference (95%CI, 0.067-0.154; p<0.001). From LBP group internal analysis, statistically, there was no ABI difference beetwen groups of different clinical appearance (local vs radiating pain, p=0.065; negative vs positive neurologic deficits, p=0.729; negative vs positive Lasegue sign, p=0.868). Conclusion: Subjects with chronic LBP had significantly lower ABI compared to subjects without chronic LBP. But, ABI did not correlate with the clinical appearance of LBP—pain type, neurologic deficits, or Lasegue sign.
|Publication status||Published - 2010|