Trends in lumbar degenerative spine pathologies causing severe pain and disability: a four-decade cohort study of 1495 Colombian women

Abstract

Study design

Retrospective Cohort Study.

Objectives

This study aimed to analyze trends in the frequency of degenerative lumbar spine pathologies in a large Colombian women cohort and their relationship with age, comorbidities, and the degree of functional limitation and pain intensity.

Materials and methods

This is a 4-decade retrospective study analyzing the clinical records of a cohort of Colombian women who sought consultation for lumbar pain at a specialized spine pathology management center. Demographic variables, comorbidities, and pain and disability scales were analyzed.

Results

A cohort of 1495 women who presented with lumbar pain between 1993 and 2024 was analyzed. The most frequent pathology over the decades was degenerative disc disease. The diagnosis of facet osteoarthritis increased significantly, from < 1% in decade 1 (1993–1999) to > 30% in decade 4 (2020–2024) (p < 0.001). Concomitant diagnosis of DDD and facet arthrosis showed a linear upward trend, rising from 0% in D1 to 24% in D4, reflecting evolving diagnostic standards. Being a homemaker between the ages of 20 and 60 was a significant factor related to back pain. Pain and disability were higher in older patients.

Conclusion

Diagnostic analyses must consider the multifactorial nature of lumbar pain and not underestimate facet arthrosis as a pain generator. The occupation of women plays an important role in back pain and its intensity, so it should be considered in the anamnesis process of medical consultation. These results originate from a single-center cohort, which must be considered when interpreting the frequency of these pathologies.