Skip to main content
Erschienen in: European Spine Journal 2/2012

01.02.2012 | Original Article

MRI findings are more common in selected patients with acute low back pain than controls?

verfasst von: Mark Hancock, Chris Maher, Petra Macaskill, Jane Latimer, Walter Kos, Justin Pik

Erschienen in: European Spine Journal | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study is to investigate if lumbar disc pathology identified on MRI scans is more common in patients with acute, likely discogenic, low back pain than matched controls.

Methods

We compared rates of MRI findings between 30 cases with low back pain and 30 pain-free controls. Cases were patients presenting for care with likely discogenic low back pain (demonstrated centralisation with repeated movement testing), of moderate intensity and with minimal past history of back pain. Controls were matched for age, gender and past history of back pain. Cases and controls underwent MRI scanning which was read for the presence of a range of MRI findings by two blinded assessors.

Results

The presence of disc degeneration, modic changes and disc herniation significantly altered the odds of a participant being a case or control. For example subjects were 5.2 times more likely to be a case than a control when disc degeneration grade of ≥3 was present, and 6.0 times more likely with modic changes. The presence of a high-intensity zone or annular tear was found to significantly alter odds for one assessor but not the other assessor.

Conclusion

MRI findings including disc degeneration, modic changes and herniation are more common in selected people with current acute (likely discogenic) low back pain than in controls without current low back pain. Further investigation of the value of MRI findings as prognostic factors and as treatment effect modifiers is required to assess the potential clinical importance of these findings.
Literatur
1.
Zurück zum Zitat van Tulder M, Becker A, Bekkering T, Breen A, del Real MTG, Hutchinson A, Koes B, Laerum E, Malmivaara A, Cost B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care (2006) Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 15(Suppl 2):S169–S191PubMedCrossRef van Tulder M, Becker A, Bekkering T, Breen A, del Real MTG, Hutchinson A, Koes B, Laerum E, Malmivaara A, Cost B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care (2006) Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 15(Suppl 2):S169–S191PubMedCrossRef
2.
Zurück zum Zitat Australian Acute Musculoskeletal Pain Guidelines Group (2004) Evidence-based management of acute musculoskeletal pain—a guide for clinicians. Australian Academic Press, Bowen Hills Australian Acute Musculoskeletal Pain Guidelines Group (2004) Evidence-based management of acute musculoskeletal pain—a guide for clinicians. Australian Academic Press, Bowen Hills
3.
Zurück zum Zitat Deyo RA (2004) Treatments for back pain: can we get past trivial effects? Ann Intern Med 141:957–958PubMed Deyo RA (2004) Treatments for back pain: can we get past trivial effects? Ann Intern Med 141:957–958PubMed
4.
Zurück zum Zitat Keller A, Hayden J, Bombardier C, van Tulder M (2007) Effect sizes of non-surgical treatments of non-specific low-back pain. Eur Spine J 16:1776–1788PubMedCrossRef Keller A, Hayden J, Bombardier C, van Tulder M (2007) Effect sizes of non-surgical treatments of non-specific low-back pain. Eur Spine J 16:1776–1788PubMedCrossRef
5.
Zurück zum Zitat Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. IASP Press, Seattle Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. IASP Press, Seattle
6.
Zurück zum Zitat Standards Committee of the International Spine Intervention Society (2004) International Spine Intervention Society practice guidelines for spinal diagnostic and treatment procedures In: Bogduk N (ed) International Spine Intervention Society Standards Committee of the International Spine Intervention Society (2004) International Spine Intervention Society practice guidelines for spinal diagnostic and treatment procedures In: Bogduk N (ed) International Spine Intervention Society
7.
Zurück zum Zitat Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N (1995) The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 20:1878–1883PubMedCrossRef Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N (1995) The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 20:1878–1883PubMedCrossRef
8.
Zurück zum Zitat Hancock MJ, Maher CG, Latimer J, Spindler MF, McAuley JH, Laslett M, Bogduk N (2007) Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 16:1539–1550PubMedCrossRef Hancock MJ, Maher CG, Latimer J, Spindler MF, McAuley JH, Laslett M, Bogduk N (2007) Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 16:1539–1550PubMedCrossRef
9.
Zurück zum Zitat Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331:69–73PubMedCrossRef Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331:69–73PubMedCrossRef
10.
Zurück zum Zitat Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72:403–408PubMed Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72:403–408PubMed
11.
Zurück zum Zitat Cheung KM, Karppinen J, Chan D, Ho DW, Song YQ, Sham P, Cheah KS, Leong JC, Luk KD (2009) Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine 34:934–940PubMedCrossRef Cheung KM, Karppinen J, Chan D, Ho DW, Song YQ, Sham P, Cheah KS, Leong JC, Luk KD (2009) Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine 34:934–940PubMedCrossRef
12.
Zurück zum Zitat Jarvik JJ, Hollingworth W, Heagerty P, Haynor DR, Deyo RA (2001) The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine 26:1158–1166PubMedCrossRef Jarvik JJ, Hollingworth W, Heagerty P, Haynor DR, Deyo RA (2001) The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine 26:1158–1166PubMedCrossRef
13.
Zurück zum Zitat Laslett M, Aprill CN, McDonald B, Oberg B, Laslett M, Aprill CN, McDonald B, Oberg B (2006) Clinical predictors of lumbar provocation discography: a study of clinical predictors of lumbar provocation discography. Eur Spine J 15:1473–1484PubMedCrossRef Laslett M, Aprill CN, McDonald B, Oberg B, Laslett M, Aprill CN, McDonald B, Oberg B (2006) Clinical predictors of lumbar provocation discography: a study of clinical predictors of lumbar provocation discography. Eur Spine J 15:1473–1484PubMedCrossRef
14.
Zurück zum Zitat Donelson R, Aprill C, Medcalf R, Grant W (1997) A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and anular competence. Spine 22:1115–1122PubMedCrossRef Donelson R, Aprill C, Medcalf R, Grant W (1997) A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and anular competence. Spine 22:1115–1122PubMedCrossRef
15.
Zurück zum Zitat Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878PubMedCrossRef Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878PubMedCrossRef
16.
Zurück zum Zitat Aprill C, Bogduk N (1992) High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. Br J Radiol 65:361–369PubMedCrossRef Aprill C, Bogduk N (1992) High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. Br J Radiol 65:361–369PubMedCrossRef
17.
Zurück zum Zitat Fardon DF, Milette PC, Combined Task Forces of the North American Spine Society ASoSR, American Society of N (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine 26:E93–E113PubMedCrossRef Fardon DF, Milette PC, Combined Task Forces of the North American Spine Society ASoSR, American Society of N (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine 26:E93–E113PubMedCrossRef
18.
Zurück zum Zitat Jensen TS, Karppinen J, Sorensen JS, Niinimaki J, Leboeuf-Yde C (2008) Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J 17:1407–1422PubMedCrossRef Jensen TS, Karppinen J, Sorensen JS, Niinimaki J, Leboeuf-Yde C (2008) Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J 17:1407–1422PubMedCrossRef
Metadaten
Titel
MRI findings are more common in selected patients with acute low back pain than controls?
verfasst von
Mark Hancock
Chris Maher
Petra Macaskill
Jane Latimer
Walter Kos
Justin Pik
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 2/2012
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-1955-7

Weitere Artikel der Ausgabe 2/2012

European Spine Journal 2/2012 Zur Ausgabe

Announcements

Announcements

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.