MRI Findings and Low Back Pain - 10 Year Longitudinal Analysis

MRI Findings and Low Back Pain - 10 Year Longitudinal Analysis -

Tonosu J et al. The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis. PLOS one: 2017

  • Primary aim of study was to investigate if any of the findings on initial MRI were associated with LBP during the next 10 years. The secondary aim was to investigate if the presence of MRI findings at baseline predicted future LBP
  • 91 participants with a history of LBP but without current LBP were included in study. 49 volunteers participated in the follow-up. They were all asked if they experienced lbp during the 10 year b/w baseline and follow-up but were not asked if LBP was a single episode or multiple episodes.
  • Follow-up MRI scans were performed by an orthopedist who was blinded to participants’ backgrounds. The authors evaluated the degree of disc degeneration, disc bulging, high-intensity zone (HIZ) spondylolisthesis, and Modic changes at each level of the spine.
  • Of the 49 participants, 36 had a history of LBP during the 10 years b/w baseline and follow-up.
  • Compared with the group w/o LBP history during the 10 years, the group that did develop LBP did not have a significantly increased incidence in disc degeneration in the follow-up MRIs compared to baseline. Additionally, no significant increase in disc bulging b/w the two groups was present.
  • Only two participants had spondylolisthesis in both baseline and follow-up groups. Of those two, only one had a history of LBP in the 10 years b/w. There was no case of progression of spondy.
  • Modic type 1 changes were only identified in one participant. Progress of HIZ was also not significantly related to LBP history during the 10 years.
  • Limitations: study findings are limited and not generalizable due to small sample size. Selection bias was present as they were volunteers from hospital and did not represent the general population.