Fatores determinantes entre dor na coluna vertebral e a sua relação com achados radiológicos em idosos

Abstract

Introduction: Spinal pain is a very common complaint in aging and it is associated with several problems that can be identified in radiological examinations. However, at clinical practice, there may be some variance related to radiological findings and to pain intensity felt by the elderly. Objective: Identify the contributing factors of pain in the spine through radiological findings in the elderly. Methods: An observational, descriptive, analytical cross-sectional study that included elderly individuals with radiological findings related to pain in the spine. The evaluation was performed through a semi-structured questionnaire, followed by an evaluation of the general health perception through the WHOQOL-Bref questionnaire, by the pain level evaluation using the Visual Analogue Pain Scale, by the evaluation of the pain-related functional disability by the Oswestry questionnaire, by a screening of depressive symptoms through the Geriatric Depression Scale (EDG) and by the index of radiological changes, from March to November 2017, in Farroupilha, RS - Brazil. For the correlations, the univariate and multivariate regressions were considered, as well as the chi-square test, and also considered a significance of 5%. The study was approved by PUCRS Ethical Research Committee, under the number 64103416.7.0000.5336. Results: A total of 101 elderly individuals aged between 60 and 91 were included. Life satisfaction was progressively worse for higher levels of pain (p=0,034); osteoarthritis (p=0,030) and diabetes (p=0,039) were related with higher and lower pain intensity, respectively. The most common radiological alterations were decreased disc space (100%), osteophytes (98%) and arthrosis (74%). The alterations related to worse pain levels were arthrodesis (p<0,001), spondylolisthesis (p=0,003), stenosis of the foraminal canal (p=0,015) and hyperkyphosis (p=0,046). The disability was worse at higher levels of pain (p<0,001). The radiological changes related to disability were: arthrosis (p=0,012); arthrodesis (p=0,013); scoliosis (p<0,001); spondylolisthesis (p=0,010); stenosis of the foraminal canal (p=0,035), and osteophytes (p=0,003). The age factor is related to worse levels of disability (p=0,022). Conclusion: The study showed that the intensity of pain is associated with present radiological changes. More severe pain causes greater levels of disability, in which most advanced age and radiological changes that were seen in X ray should be taken into account as they may influence disability.