Low-field magnetic resonance imaging of the lumbar spine: reliability of qualitative evaluation of disc and muscle parameters

Sorensen, Solgaard J.; Kjær, Per; Jensen, Tue Secher; Andersen, Poul Erik

doi:10.1080/02841850600965062

Cited by 77 publications

(79 citation statements)

References 26 publications

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“…The MRI evaluation, at baseline, was performed by a musculoskeletal radiologist (JSS) with extensive MRI experience and trained in using the standardized evaluation protocols [23,24] used in this study. MCs were evaluated according to the Nordic Modic Consensus Group classification [23], which had shown substantial to almost perfect reproducibility with Kappa values for intra-observer reproducibility (k = 0.77 to 1.0) and inter-observer reproducibility (k = 0.73 to 0.91).…”

Section: Methodsmentioning

confidence: 99%

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Jensen

Leboeuf‐Yde

Wedderkopp

et al. 2012

BMC Med

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BackgroundClinical experience suggests that many patients with Modic changes have relatively severe and persistent low back pain (LBP), which typically appears to be resistant to treatment. Exercise therapy is the recommended treatment for chronic LBP, however, due to their underlying pathology, Modic changes might be a diagnostic subgroup that does not benefit from exercise. The objective of this study was to compare the current state-of-the art treatment approach (exercise and staying active) with a new approach (load reduction and daily rest) for people with Modic changes using a randomized controlled trial design.MethodsParticipants were patients from an outpatient clinic with persistent LBP and Modic changes. They were allocated using minimization to either rest therapy for 10 weeks with a recommendation to rest for two hours daily and the option of using a flexible lumbar belt or exercise therapy once a week for 10 weeks. Follow-up was at 10 weeks after recruitment and 52 weeks after intervention and the clinical outcome measures were pain, disability, general health and global assessment, supplemented by weekly information on low back problems and sick leave measured by short text message (SMS) tracking.ResultsIn total, 100 patients were included in the study. Data on 87 patients at 10 weeks and 96 patients at one-year follow-up were available and were used in the intention-to-treat analysis. No statistically significant differences were found between the two intervention groups on any outcome.ConclusionsNo differences were found between the two treatment approaches, 'rest and reduced load' and 'exercise and staying active', in patients with persistent LBP and Modic changes.Trial RegistrationClinicalTrials.gov: NCT00454792

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Section: Methodsmentioning

confidence: 99%

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Jensen

Leboeuf‐Yde

Wedderkopp

et al. 2012

BMC Med

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“…On the day of study they filled in questionnaires, had an MRI of the lumbar spine, and were submitted to a physical examination. The study has been described in detail previously [14,31] and its relevant aspects are described below. For a description of the strengths and weaknesses of the study refer to PhD thesis [14].…”

Section: Study Participants and Proceduresmentioning

confidence: 99%

“…For this study, T1-and T2-weighted sagittal and axial T1-weighted sequences were used [31]. All images were described by an experienced radiologist according to a set protocol.…”

Section: Data Collection and Research Variablesmentioning

confidence: 99%

“…MC is associated with low back pain (LBP) in the general population [31] and observation from our outpatients' clinic is that a large proportion of patients with persistent LBP have MC and in an in-house clinical study, patients with sciatica who were treated conservatively were three times as likely to report LBP if they had developed MC at 14 months follow-up as those who had not [1].…”

Section: Introductionmentioning

confidence: 99%

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Modic changes and their associations with clinical findings

et al. 2006

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It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all. In a population-based sample of 412 40-year-old Danes, information was collected independently with MRI, questionnaires and clinical examination. Three subgroups of people were created: those with both DD and MC, those with only DD, and those with neither DD nor MC. The clinical pattern was investigated for each subgroup in order to test the assumption that the clinical picture differs in the three groups. It was expected that people with both DD and MC would have a more pronounced clinical profile than those with only DD who, in turn, would differ from those with neither of these two MRI findings. Our findings were generally in concordance with our expectations. MC constitutes the crucial element in the degenerative process around the disc in relation to LBP, history, and clinical findings. People with DD and no MC only vaguely differ from those without. People with LBP and MC may deserve to be diagnosed as having specific LBP.

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“…The radiologist has previously demonstrated ability to do reliable readings of lumbar MRI [34]. For description of variables and gradings, see Table 1.…”

Section: Mri Procedures and Variablesmentioning

confidence: 99%

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

et al. 2008

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Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rearend or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5-6 and C6-7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis.

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Low-field magnetic resonance imaging of the lumbar spine: reliability of qualitative evaluation of disc and muscle parameters

Abstract: Convincing reliability was found in the evaluation of disc- and muscle-related MRI variables.

Cited by 77 publications

References 26 publications

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Modic changes and their associations with clinical findings

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

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