The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects - A seven-year follow-up study

Citation
Dg. Borenstein et al., The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects - A seven-year follow-up study, J BONE-AM V, 83A(9), 2001, pp. 1306-1311
Citations number
10
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
ISSN journal
0021-9355 → ACNP
Volume
83A
Issue
9
Year of publication
2001
Pages
1306 - 1311
Database
ISI
SICI code
0021-9355(200109)83A:9<1306:TVOMRI>2.0.ZU;2-T
Abstract
Background: In 1989, a group of sixty-seven asymptomatic individuals with n o history of back pain underwent magnetic resonance imaging of the lumbar s pine. Twenty-one subjects (31%) had an identifiable abnormality of a disc o r of the spinal canal. In the current study, we investigated whether the fi ndings on the scans of the lumbar spine that had been made in 1989 predicte d the development of low-back pain in these asymptomatic subjects. Methods: A questionnaire concerning the development and duration of low-bac k pain over a seven-year period was sent to the sixty-seven asymptomatic in dividuals from the 1989 study. A total of fifty subjects completed and retu rned the questionnaire. A repeat magnetic resonance scan was made for thirt y-one of these subjects. Two neuroradiologists and one orthopaedic spine su rgeon interpreted the original and repeat scans in a blinded fashion, indep endent of clinical information. At each disc level, any radiographic abnorm ality, including bulging or degeneration of the disc, was identified. Radio graphic progression was defined as increasing severity of an abnormality at a specific disc level or the involvement of additional levels. Results: Of the fifty subjects who returned the questionnaire, twenty-nine (58%) had no back pain. Low-back pain developed in twenty-one subjects duri ng the seven-year study period. The :1989 scans of these subjects demonstra ted normal findings in twelve, a herniated disc in five, stenosis in three, and moderate disc degeneration in one. Eight individuals had radiating leg pain; four of them had had normal findings on the original scans, two had had spinal stenosis, one had had a disc protrusion, and one had had a disc extrusion. In general, repeat magnetic resonance imaging scans revealed a g reater frequency of disc herniation, bulging, degeneration, and spinal sten osis than did the original scans. Conclusions: The findings on magnetic resonance scans were not predictive o f the development or duration of low-back pain. Individuals with the longes t duration of low-back pain did not have the greatest degree of anatomical abnormality on the original, 1989 scans. Clinical correlation is essential to determine the importance of abnormalities on magnetic resonance images.