Related Experiment Video
Updated: Aug 13, 2026
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Associations between back pain history and lumbar MRI findings
Tapio Videman1, Michele C Battié, Laura E Gibbons
1University of Alberta, Edmonton, Alberta, Canada. tapio.videman@ualberta.ca
Study Design:
Retrospective monozygotic twin cohort study.
Objectives:
Our goal was to investigate the associations between different spinal MRI findings and current, past year, and lifetime low back pain after adjusting for occupational physical loading, smoking, genetics, and early family influences.
Summary Of Background Data:
The role of spinal pathology in back symptoms continues to be controversial.
Methods:
The study participants consisted of 115 monozygotic male twin pairs 35 to 69 years of age. The qualitatively assessed MRI parameters were as follows: disc height, bulging, herniations, anular tears, osteophytes, spinal stenosis, and endplate changes. Signal intensity was measured quantitatively.
Results:
After controlling for age, disc height was associated with all back pain variables studied and anular tears with LBP frequency and intensity during the 12 months before imaging. Both were associated with lifetime frequency of low back pain interfering with daily activities, disability, and intensity of the worst lifetime pain episode. Other MRI findings did not explain the various symptom histories. Adjusting for physical loading in the past 12 months increased the associations of anular tears and "low back pain today" and 12-month low back pain parameters. After controlling for genotype and other familial influences, the within-pair differences in disc height and anular tears accounted for 6% to 12% of the total variance in the within-pair differences of low back pain variables.
Conclusion:
These findings raise new questions about the underlying mechanisms of LBP. The sensitivities of the only significant MRI parameters, disc height narrowing and anular tears, are poor, and these findings alone are of limited clinical importance.
Insights
Spinal MRI findings like disc height and anular tears are linked to low back pain (LBP). However, these imaging results alone have limited clinical importance for diagnosing LBP.
Area of Science:
- Orthopedics
- Radiology
- Pain Medicine
Background:
- The connection between spinal pathology and low back pain (LBP) remains debated.
- Understanding LBP etiology requires differentiating imaging findings from symptoms.
Purpose of the Study:
- To investigate associations between spinal MRI findings and current, past year, and lifetime LBP.
- To adjust for occupational physical loading, smoking, genetics, and family influences in LBP analysis.
Main Methods:
- Retrospective monozygotic twin cohort study of 115 male twin pairs (35-69 years).
- Qualitative MRI assessment included disc height, bulging, herniations, anular tears, osteophytes, spinal stenosis, and endplate changes.
- Quantitative signal intensity measurements were also performed.
Main Results:
- Disc height and anular tears were associated with various LBP measures (current, past year, lifetime).
- Adjusting for physical loading strengthened associations for anular tears and LBP.
- Within-pair differences in disc height and anular tears explained 6-12% of LBP variance.
Conclusions:
- Disc height narrowing and anular tears are the only significant MRI parameters for LBP.
- The clinical importance of these MRI findings alone is limited due to poor sensitivity.
- New questions arise regarding the underlying mechanisms of LBP.
![Quantitative [18F]-Naf-PET-MRI Analysis for the Evaluation of Dynamic Bone Turnover in a Patient with Facetogenic Low Back Pain](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F58491.jpg&w=3840&q=50)
