Causes of Adolescent Low Back Pain: A Retrospective Study

Abstract

Objective

To add to the body of evidence in the scientific literature with respect to the etiology of adolescent back pain.

Design

A retrospective chart review was conducted over a 3 year period. Charts were initially rendered using International Classification of Disease, 10th Revision (ICD-10) diagnosis, and subsequently narrowed down to age range of 10-19 years. Additionally, patients with documented trauma requiring emergent spinal surgery or an alternative diagnosis (eg, hip pain) were excluded.

Setting

This study was performed in a large United States based private multispecialty orthopedic practice. This includes 30 different ambulatory office locations in multiple demographic regions.

Participants

Patients ages 10 to 19 years old who presented with documented low back pain (LBP) were included. A total of N = 1932 patients were included with a 1.1/1 women to men ratio. The study was conducted over a 3 year period (2015-2018).

Interventions

Not applicable.

Main Outcome Measures

Final diagnosis reached by clinician, verified by chart and imaging review.

Results

A total of 1932 patients were included: 1010 (52.3%) women and 922 (47.7%) men. Physician reviewers grouped the diagnoses into comprehensive categories. LBP without a specific cause was the most common diagnosis with 827 patients (42.81%). Women accounted for 447 (54.0%) of the patients diagnosed with LBP, whereas men accounted for 380 (46.0%). Disk disease was the second most common diagnosis representing 534 study participants (27.64%). There were more women than men in the overall disk cohort with 304 (30.10%) and 230 (24.95%), respectively. Spondylolysis was the third most common diagnosis with 281 patients (14.54%). The prevalence was higher for men than women, 192 (20.82%) and 89 (8.81%), respectively.

Conclusions

A clearer understanding of the various etiologies associated with general LBP was obtained. The findings reveal a higher occurrence of disk-related issues compared with previous data and highlight gender-based differences in the identified pathologies.