Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct 14:12:234.
doi: 10.1186/1471-2474-12-234.

Predictors of long-term pain and disability in patients with low back pain investigated by magnetic resonance imaging: a longitudinal study

Philip McNee  1 , James Shambrook, E Clare Harris, Miranda Kim, Madeleine Sampson, Keith T Palmer, David Coggon
Affiliations

Predictors of long-term pain and disability in patients with low back pain investigated by magnetic resonance imaging: a longitudinal study

Philip McNee et al. BMC Musculoskelet Disord. .

Abstract

Background: It is possible that clinical outcome of low back pain (LBP) differs according to the presence or absence of spinal abnormalities on magnetic resonance imaging (MRI), in which case there could be value in using MRI findings to refine case definition of LBP in epidemiological research. We therefore conducted a longitudinal study to explore whether spinal abnormalities on MRI for LBP predict prognosis after 18 months.

Methods: A consecutive series of patients aged 20-64 years, who were investigated by MRI because of mechanical LBP (median duration of current episode 16.2 months), were identified from three radiology departments, and those who agreed completed self-administered questionnaires at baseline and after a mean follow-up period of 18.5 months (a mean of 22.2 months from MRI investigation). MRI scans were assessed blind to other clinical information, according to a standardised protocol. Associations of baseline MRI findings with pain and disability at follow-up, adjusted for treatment and for other potentially confounding variables, were assessed by Poisson regression and summarised by prevalence ratios (PRs) with their 95% confidence intervals (CIs).

Results: Questionnaires were completed by 240 (74%) of the patients who had agreed to be followed up. Among these 111 men and 129 women, 175 (73%) reported LBP in the past four weeks, 89 (37%) frequent LBP, and 72 (30%) disabling LBP. In patients with initial disc degeneration there was an increased risk of frequent (PR 1.3, 95%CI 1.0-1.9) and disabling LBP (PR 1.7, 95%CI 1.1-2.5) at follow-up. No other associations were found between MRI abnormalities and subsequent outcome.

Conclusions: Our findings suggest that the MRI abnormalities examined are not major predictors of outcome in patients with LBP. They give no support to the use of MRI findings as a way of refining case definition for LBP in epidemiological research.

PubMed Disclaimer

References

    1. Endean A, Palmer KT, Coggon D. Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: A systematic review. Spine. 2011;36:160–9. doi: 10.1097/BRS.0b013e3181cd9adb. - DOI - PMC - PubMed
    1. Shambrook J, McNee P, Harris EC, Kim M, Sampson M, Palmer KT, Coggon D. Clinical presentation of low back pain and association with risk factors according to findings on magnetic resonance imaging. Pain. 2011;152:1659–65. doi: 10.1016/j.pain.2011.03.011. - DOI - PMC - PubMed
    1. Ware JE. SF-36 Health Status Questionnaire. Institute for the Improvement of Medical Care and Health, New England Medical Center Hospital, Quality Quest Inc Boston, MA; 1989.
    1. Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychological Medicine. 1983;13:595–605. doi: 10.1017/S0033291700048017. - DOI - PubMed
    1. Roland M, Morris R. A study of the natural history of low-back pain: Part I. Development of a reliable and sensitive measure of disability in low-back pain. Spine. 1983;8:141–144. doi: 10.1097/00007632-198303000-00004. - DOI - PubMed

Publication types