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

Mark Hancock1, Chris Maher, Petra Macaskill

  • 1Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia. mark.hancock@sydney.edu.au

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|August 9, 2011
PubMed
Abstract

Insights

Lumbar disc pathology, including degeneration, modic changes, and herniation, is more prevalent in individuals experiencing acute low back pain compared to pain-free controls. These MRI findings are significant indicators in patients with discogenic low back pain.

Area of Science:

  • Radiology
  • Orthopedics
  • Spine Health

Background:

  • Low back pain is a prevalent condition with diverse etiologies.
  • Magnetic Resonance Imaging (MRI) is a key diagnostic tool for evaluating spinal structures.
  • Discogenic pain, originating from intervertebral discs, is a common cause of low back pain.

Purpose of the Study:

  • To determine if specific lumbar disc pathologies detected via MRI are more frequent in patients with acute, likely discogenic, low back pain.
  • To compare the incidence of MRI-identified disc abnormalities between patients with acute low back pain and matched pain-free individuals.

Main Methods:

  • A case-control study involving 30 patients with acute, likely discogenic low back pain and 30 matched pain-free controls.
  • Cases exhibited centralisation with repeated movements and had minimal prior back pain history.
  • MRI scans were analyzed by two blinded assessors for various findings, including disc degeneration, modic changes, and herniation.

Main Results:

  • Disc degeneration (grade ≥3), modic changes, and disc herniation were significantly more common in cases than controls.
  • Participants with disc degeneration grade ≥3 were 5.2 times more likely to be cases, and those with modic changes were 6.0 times more likely.
  • High-intensity zones and annular tears showed inconsistent significance between assessors.

Conclusions:

  • MRI-detected lumbar disc pathologies such as degeneration, modic changes, and herniation are more common in individuals with acute discogenic low back pain.
  • These findings suggest a potential link between specific MRI abnormalities and current episodes of low back pain.
  • Further research is needed to establish the prognostic value and clinical significance of these MRI findings in managing low back pain.

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