Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain

Carragee, Eugene J.; Alamin, Todd F.; Miller, Jonothan; Carragee, John M.

doi:10.1016/j.spinee.2004.05.250

Cited by 363 publications

(210 citation statements)

References 47 publications

Supporting

Mentioning

187

Contrasting

Unclassified

Order By: Relevance

“…Only patients with a relatively large, conclusive M1 were included, since such more definite hypointensities (on T1WI) have been found to correlate with LBP [5,13]. Elderly people (over 60 years old) were excluded because of the common, age-dependent, degenerative changes in intervertebral discs and bone marrow, which may hamper the assessment of the subchondral abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Subchondral signal abnormalities have been found to be associated with LBP [2,3,5,11,26], particularly with hypointensities [2,13,23]. Subchondral edema-like hypointensity on T1 weighted image (T1WI), being hyperintense on T2 weighted image (T2WI), has been found in association with vascularized fibrous tissue and with fissuring or disruption in the adjacent end plates [17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients

et al. 2008

View full text Add to dashboard Cite

Subchondral signal abnormalities have been suggested to play an important role in chronic low back pain (LBP) syndromes. Their natural course is not well known. In this study the morphology and natural course of isolated subchondral signal abnormalities in the lumbosacral spine were analyzed with MRI. Twenty-four chronic LBP patients with a subchondral hypointensity on T1-weighted image (hyperintense on T2), indicating edema, were selected from a base population of 1,015 consecutive LBP patients to a follow-up MRI study within 18-72 months. Exclusion criteria were age [60 years, nerve root compression, a more specific back disease or a recent or major spine operation. The size and location of each subchondral signal abnormality and endplate lesion and the degree of degenerative disc changes were evaluated and compared between the baseline and follow-up studies. Most subchondral hypointensities were found at the L4/L5 or L5/S1 disc space, anteriorly and in both adjacent endplates. Almost all (53/54) hypointensities were associated with an endplate lesion. Twelve of the 54 subchondral hypointensities enlarged, six remained constant and 36 decreased or disappeared while five new ones appeared. Twenty-two (41%) hypointensities changed totally to hyperintensities or to mixed lesions. If the hypointensity increased, decreased or changed into hyperintensity, a change tended to develop in the adjacent endplate. If the hypointensity was absent or unchanged, endplate lesions did not tend to progress. In the absence of disc herniation or other specific spinal disease, subchondral hypointensities indicating edema are uncommon. They seem to have a highly variable course. There appears to be a link between endplate lesions and subchondral signal abnormalities. Further study is needed to explain the contribution of these findings to low back symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients

et al. 2008

View full text Add to dashboard Cite

show abstract

“…The Distress Risk Assessment Method is a 45-item patient questionnaire that is frequently used to quantify psychological distress in patients presenting for orthopaedic care [3,7,8,21,31]. It includes the modified Zung Depression Scale and the MSPQ, and the scores on these two questionnaires are combined to stratify patients into normal, atrisk, and distressed groups, which represent increasing levels of depressive and somatic symptomatology [18].…”

Section: Description Of Followup Routinementioning

confidence: 99%

“…Higher levels of psychological distress correlate with greater pain and decreased function in patients with low back pain [3,10], surgical spine conditions [1,4,31,32], hip and knee arthritis [11,14,16], femoroacetabular impingement [22,24], shoulder and rotator cuff pathology [6,23,27,28], and orthopaedic hand and elbow conditions [17,25,33,34].…”

Section: Introductionmentioning

confidence: 99%

One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Potter

Wylie

Greis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Patients with shoulder and rotator cuff pathology who exhibit greater levels of psychological distress report inferior preoperative self-assessments of pain and function. In several other areas of orthopaedics, higher levels of distress correlate with a higher likelihood of persistent pain and disability after recovery from surgery. To our knowledge, the relationship between psychological distress and outcomes after arthroscopic rotator cuff repair has not been similarly investigated. Questions/purposes (1) Are higher levels of preoperative psychological distress associated with differences in outcome scores (visual analog scale [VAS] for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (2) Are higher levels of preoperative psychological distress associated with less improvement in outcome scores (VAS for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (3) Does the prevalence of psychological distress in a population with full-thickness rotator cuff tears change when assessed preoperatively and 1 year after arthroscopic rotator cuff repair? Methods Eighty-five patients with full-thickness rotator cuff tears were prospectively enrolled; 70 patients (82%) were assessed at 1-year followup. During the study period, the three participating surgeons performed 269 rotator cuff repairs; in large part, the low overall rate of enrollment was related to two surgeons enrolling only two patients total in the initial 14 months of the study. Psychological distress was quantified using the Distress Risk Assessment Method questionnaire, and patients completed self-assessments including the VAS for pain, the Simple Shoulder Test, and the American Shoulder and Elbow Surgeons score preoperatively and 1 year after arthroscopic rotator cuff repair. Fifty of 85 patients (59%) had normal levels of distress, 26 of 85 (31%) had moderate levels of distress, and nine of 85 (11%) had severe levels of distress. Statistical models were used to assess the effect of psychological distress on patient self-assessment of shoulder pain and function at 1 year after surgery. Results With the numbers available, distressed patients were not different from nondistressed patients in terms of One of the authors certifies that he (PEG), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 of research support funding from DePuy Mitek (Raynham, MA, USA). One of the authors certifies that he (RTB), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 of research support funding from DePuy Mitek. One of the authors certifies that he (RZT), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,000 to USD 1,000,000 of research support funding from the Depart...

show abstract

“…Some patients have a light limitation while others are severely impaired. Exhaustive research has failed to find a correlation between pain, structural damage in the spine and the level of disability in non-specific LBP [2,3]. Among the factors that predict disability and chronicity from LBP, patients' beliefs about fear-avoidance, pain-impairment relationship and coping strategies are strongly associated with outcome from treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

et al. 2012

View full text Add to dashboard Cite

Objective To develop a Spanish version of the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and to test its psychometric properties. Methods A forward and backward translation methodology was used to translate the questionnaire, which was then applied to 206 participants (174 physiotherapy students and 32 family physicians). The intraclass correlation coefficient was calculated to assess test-retest reliability. Internal consistency was evaluated using Cronbach's alpha and item analysis. Construct validity was measured using Pearson correlation coefficients between HC-PAIRS and FABQ, FABQ-Phys, FABQ-Work and the responses given by participants to three clinical case scenarios. An exploratory factor analysis was carried out following the Kaiser normalization criteria and principal axis factoring with an oblique rotation (quartimax). Sensitivity to change was assessed after a teaching module.Results Test-retest reliability was ICC 0.50 (p \ 0.01) and Cronbach's alpha was 0.825. The HC-PAIRS scores correlated significantly with the scores of the FABQ and also with the recommendations for work and activity given by the participants in the three clinical case scenarios. Sensitivity to change test showed an effect size of 1.5, which is considered a large change. Factor analysis suggests that the Spanish version of HC-PAIRS measures a unidimensional construct. Conclusion The Spanish version of the HC-PAIRS has proven to be a reliable, valid and sensitive instrument to assess health care providers' attitudes and beliefs about LBP. It can be used in evaluating clinical practice and in undergraduate acquisition of skills and knowledge.

show abstract

Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain

Cited by 363 publications

References 47 publications

MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients

MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients

One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

Contact Info

Product

Resources

About