Value of pre-employment radiographic assessment of the lumbar spine

In order to test the hypothesis that pre-employment radiographic examination provides information which permits identification of individuals who are likely to develop symptoms of lumbar pain under the stress of physical labour, the study reported was undertaken. Two groups of male labourers of minimum age 35 years were matched for important variables, and differentiated by the circumstance that one group alone had the additional characteristic of a positive history of lumbar disability. Study of the radiographs of these subjects allowed tabulation of all deviations from normal, both minor and major. A computerized comparative analysis was performed on the data. It was found that there is no developmental or degenerative change or combination of such changes which has predictive value when applied to the individual. Therefore, since this examination provides no legitimate criteria for prognostication, the hypothesis as stated is invalid, and the worth of the policy of pre-employment assessment is open to serious question.