Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study

Abstract

Population-based cohort study. Objective. We examined associations between common lumbar degenerative changes observed on magnetic resonance imaging (MRI) and present or future low back pain (LBP). Summary of Background Data. The association between lumbar MRI degenerative findings and LBP is unclear. Longitudinal studies are sparse. Methods. Participants (n ¼ 3369) from a population-based cohort study were imaged at study entry, with LBP status measured at baseline and 6-year follow-up. MRI scans were reported on for the presence of a range of MRI findings. LBP status was measured on a 0 to 10 scale. Regression models were used to estimate the cross-sectional and longitudinal associations between individual and multiple MRI findings and LBP severity.Separate longitudinal analyses were conducted for participants with and without baseline pain.Results. MRI findings were present in persons with and without back pain at baseline. Higher proportions were found in older age groups. 76.4% of participants had a least one MRI finding and 8.3% had five or more different MRI findings. Crosssectionally, most MRI findings were slightly more common in those with LBP and pain severity was slightly higher in those with MRI findings (ranging from 0.06 for high intensity zone to 0.83 for spondylolisthesis). In the longitudinal analyses, we found most MRI findings were not associated with future LBPseverity regardless of the presence or absence of baseline pain. Compared to zero MRI findings, having multiple MRI findings (five or more) was associated with mildly greater pain-severity at baseline (0.84; 0.50-1.17) and greater increase in pain-severity over 6 years in those pain free at baseline (1.21; 0.04-2.37), but not in those with baseline pain (À0.30; À0.99 to 0.38). Conclusion.Our study shows that the MRI degenerative findings we examined, individually or in combination, do not have clinically important associations with LBP, with almost all effects less than one unit on a 0 to 10 pain scale.

SHIP-MR and Radiology: 12 Years of Whole-Body Magnetic Resonance Imaging in a Single Center

“…Lumbar findings and their relationship with current and future pain was examined by Kasch et al MRI findings were common in subjects with or without pain at baseline and showed individually or in combination no clinically relevant association with future low back pain [ 27 ].…”

“Listen to me, learn from me”: a priority setting partnership for shaping interdisciplinary pain training to strengthen chronic pain care

“…For example, regarding diagnostics, the tenuous relationship between chronic back pain and pathology (imaging) 49 has implications for driving unnecessary, low-value care. 59 Helping people make sense of their chronic pain from a biopsychosocial perspective and contextualising imaging findings against age-and sex-related normative data 49 could be training targets. Reframing diagnosis towards identifying the multidimensional factors influencing a person's pain experience can help them make sense of their pain [20][21][22]29 and identify modifiable factors to support self-management, while gently countering common pain misconceptions.…”

Diagnostic accuracy of contrast and non-contrast 1.5 tesla magnetic resonance imaging for lumbar herniated nucleus pulposus based on surgical findings

“…The magnetic strength of an MRI is directly proportional to the number of signals received from the human body during an MRI scan. Since signals from the body are then used to create the image, the higher the magnetic strength, the more detailed the image, so the higher the magnetic strength, the better the detail in the image and the less the artifacts that appear Varlotta CG et al, 2020;Kasch R et al, 2022). The use of 1.5 Tesla MRI is superior in the diagnosis of pathological abnormalities in the spine due to the less possibility of artifacts on imaging duration due to bowel movements and breath than 3 Tesla MRI which is very sensitive to movements.…”

“…The findings obtained on imaging must be consistent with their usefulness in clinical practice. The benefit of MRI in identifying pathological abnormalities of the spine, especially the lumbar spine, depends on how big the role of MRI is in helping the decisionmaking for the next HNP management that affects the clinical outcome of the patient (Ekedahl H et al, 2018;Kasch R et al, 2022). This could be the role of MRI to exclude patients who have no anatomical abnormalities to avoid invasive surgical therapy (in this case avoiding false-positive findings) and vice versa to find and identify as many patients as possible with anatomic abnormalities where delaying surgical therapy could result in the poorer clinical outcome of patients (in this case avoiding false-negative numbers), so it is important to study and assess the accuracy of the selected preoperative imaging tool more deeply (Michelini G et al, 2018).…”