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Meta-Analysis
. 2015 Dec;36(12):2394-9.
doi: 10.3174/ajnr.A4498. Epub 2015 Sep 10.

MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

W Brinjikji  1 , F E Diehn  2 , J G Jarvik  3 , C M Carr  2 , D F Kallmes  2 , M H Murad  4 , P H Luetmer  2
Affiliations
Meta-Analysis

MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

W Brinjikji et al. AJNR Am J Neuroradiol. 2015 Dec.

Abstract

Background and purpose: Imaging features of spine degeneration are common in symptomatic and asymptomatic individuals. We compared the prevalence of MR imaging features of lumbar spine degeneration in adults 50 years of age and younger with and without self-reported low back pain.

Materials and methods: We performed a meta-analysis of studies reporting the prevalence of degenerative lumbar spine MR imaging findings in asymptomatic and symptomatic adults 50 years of age or younger. Symptomatic individuals had axial low back pain with or without radicular symptoms. Two reviewers evaluated each article for the following outcomes: disc bulge, disc degeneration, disc extrusion, disc protrusion, annular fissures, Modic 1 changes, any Modic changes, central canal stenosis, spondylolisthesis, and spondylolysis. The meta-analysis was performed by using a random-effects model.

Results: An initial search yielded 280 unique studies. Fourteen (5.0%) met the inclusion criteria (3097 individuals; 1193, 38.6%, asymptomatic; 1904, 61.4%, symptomatic). Imaging findings with a higher prevalence in symptomatic individuals 50 years of age or younger included disc bulge (OR, 7.54; 95% CI, 1.28-44.56; P = .03), spondylolysis (OR, 5.06; 95% CI, 1.65-15.53; P < .01), disc extrusion (OR, 4.38; 95% CI, 1.98-9.68; P < .01), Modic 1 changes (OR, 4.01; 95% CI, 1.10-14.55; P = .04), disc protrusion (OR, 2.65; 95% CI, 1.52-4.62; P < .01), and disc degeneration (OR, 2.24; 95% CI, 1.21-4.15, P = .01). Imaging findings not associated with low back pain included any Modic change (OR, 1.62; 95% CI, 0.48-5.41, P = .43), central canal stenosis (OR, 20.58; 95% CI, 0.05-798.77; P = .32), high-intensity zone (OR = 2.10; 95% CI, 0.73-6.02; P = .17), annular fissures (OR = 1.79; 95% CI, 0.97-3.31; P = .06), and spondylolisthesis (OR = 1.59; 95% CI, 0.78-3.24; P = .20).

Conclusions: Meta-analysis demonstrates that MR imaging evidence of disc bulge, degeneration, extrusion, protrusion, Modic 1 changes, and spondylolysis are more prevalent in adults 50 years of age or younger with back pain compared with asymptomatic individuals.

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References

    1. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med 2002;137:586–97 10.7326/0003-4819-137-7-200210010-00010 - DOI - PubMed
    1. Deyo RA, Cherkin D, Conrad D, et al. . Cost, controversy, crisis: low back pain and the health of the public. Annu Rev Public Health 1991;12:141–56 10.1146/annurev.pu.12.050191.001041 - DOI - PubMed
    1. Li AL, Yen D. Effect of increased MRI and CT scan utilization on clinical decision-making in patients referred to a surgical clinic for back pain. Can J Surg 2011;54:128–32 10.1503/cjs.001510 - DOI - PMC - PubMed
    1. Carragee E, Alamin T, Cheng I, et al. . Are first-time episodes of serious LBP associated with new MRI findings? Spine J 2006;6:624–35 10.1016/j.spinee.2006.03.005 - DOI - PubMed
    1. Boden SD, Davis DO, Dina TS, et al. . Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects: a prospective investigation. J Bone Joint Surg Am 1990;72:403–08 - PubMed

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