An exploratory study comparing lumbar spine magnetic resonance (MR) images of 20 lower back pain (LBP) sufferers with those of 10 control subjects over a 12-week period found that both groups had a similar number of participants whose spinal imaging demonstrated changes over time, but the LBP subjects were twice as likely as the control subjects to have a change in disc herniation, nerve root compromise, or annular fissure on their scans.
Lumbar MR Image Study
Researchers sought to explore the clinical significance of lumbar MR image findings in diagnosing and treating patients with LBP—the leading cause of disability worldwide. Because it is often difficult to identify the underlying cause of LBP in patients, the researchers involved in the study were seeking to clarify the role of imaging in helping to diagnose and treat LBP.
The study included two groups—one group of 20 subjects who suffered from LBP, and a control group of 10 individuals who had experienced no LBP within the past 12 months. The two groups were given baseline MRI scans and then more scans at 1, 2, 6, and 12 weeks. The scans were compared by a clinical radiologist at the end of the 12-week period to determine the proportion of control and LBP subjects whose scans had demonstrated spinal changes during the study. The radiologist was unaware of which group each image belonged to prior to studying the scans.
Lumbar MRI Results
Eighty-five percent of the LBP subjects had at least one change in their MR imaging during the 12-weeks, and roughly 80 percent of the control subjects demonstrated at least a single change in their study scans. Significantly, the LBP subjects were twice as likely to exhibit changes in disc herniation, annular fissures, or root compromise as the control group subjects. Aside from these changes, the two groups were similar in their MR change proportions, and neither group demonstrated changes in facet joint arthropathy, canal stenosis, and spondylolisthesis or retrolisthesis.
Back Pain Subjects Had Twice as Many Degenerative Changes in Lumbar MRIs
The study’s researchers were surprised at the significant (double) proportion of LBP sufferers’ changes in disc herniation, root compromise, and annular fissures, as compared to the control group. They theorized that the reason for the similarity of change proportions in the control and LBP group’s MR imaging is that the control group changes represented “true” changes that occur naturally over time. It is also possible that differing imaging postures or techniques across the various scans could account for some of the similarities in image changes. They suggest future studies compare images of acute LBP subjects to a control group for a better perspective on the significance of these findings.