Compensation of MRI findings in asymptomatic patients with chronic low back pain

Abstract

Objective: Chronic low back pain can originate from a number of constructs. It has a range of pathologies depending on multifactorial causes. In this study, we aimed to investigate in asymptomatic patients who compensation complaint of chronic low back pain in our outpatient clinic and demonstrate its for functionality in treatment planning. Material and Methods: Magnetic Resonance Imaging (MRI) results of 78 asymptomatic patients (46 males, 32 females) who complained of low back pain for at least 12 weeks atMarch 2016 - January 2017 were examined. During MRI assessments, T1 and T2 weighted sagittal plane and transaxial images of the lumbar region (L1-S1) and radiology reports of these images were obtained for all patients.  Degenerative disc disease, Bulging protrusion, Spinal canal stenosis and Nerve root compression re-evaluated and patient findings were assessed. Results: There was no abnormality in the MRI results of 16 patients (20%) examined within the study criteria.  Nerve root compression was detected in 17 patients (22%), spinal stenosis in 24 patients (30%) and disc degeneration or bulging in 57 patients (78%). There was no statistically significant difference in the incidence of pathologies by asymptomatic patient findings. Conclusion: Chronic back pain is a disease that involves a wide range of pathologies. MRI scan provides detailed images to the clinician, it is difficult to make a specific diagnosis in the majority of patients with low back pain. Difficulty should be taken into account that the findings obtained by the clinician during assessment can also be seen in asymptomatic individuals

Keywords

• low back pain,MRI,asymptomatic

References

1. 1. Gilgil E, Kaçar C, Bütün B, Tuncer T, Urhan S, Yildirim C,Sünbüloglu G, Arikan V, Tekeoglu I, Oksüz MC, Dündar U. Prevalence of low back pain in a developing urban setting. Spine. 2005; 30(9):1093–8.
2. 2. Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation. 2014; 17 2:3–10.
3. 3. Hwang MH, Cho DH, Baek SM, Lee JW, Park JH, Yoo CM, Shin JH, Nam HG, Son HG, Lim HJ, Cho HS, Moon HJ, Kim JH, Lee JK, Choi H. Spine-on-a-chip: Human annulus fibrosus degeneration model for simulating the severity of intervertebral disc degeneration. Biomicrofluidics. 2017; 6;11 (6):064107.
4. 4. Ng SK, Urquhart DM, Fitzgerald PB, Cicuttini FM, Hussain SM, Fitzgibbon BM. The Relationship between Structural and Functional Brain Changes and Altered Emotion and Cognition in Chronic Low Back Pain: A Systematic Review of MRI and fMRI Studies. Clin J Pain. 2017; (7) 17
5. 5. Samanta J, Julia K, Ash S. Chronic low back pain. Bmj 2003; 326.7388:535.
6. 6. Kjaer P, Leboeuf C, Korsholm L, Sorensen JS, Bendix T. Magnetic resonance imaging and low back pain in adults: A diagnostic imaging study of 40 year old men and women. Spine 2005; 30: 1173-80.
7. 7. Tonosu J, Oka H, Higashikawa A, Okazaki H, Tanaka S, Matsudaira K. The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis. 2017; 10, 15; 12(11):e0188057
8. 8. Rao A, Mishra A, Pimpalwar Y, Sahdev R, Yadu N. Incorporation of Whole Spine Screening in Magnetic Resonance Imaging Protocols for Low Back Pain: A Valuable Addition. Asian Spine J. 2017; 10, 11(5):700-705.

9. 9. Greenberg, Jack O., Roger G.S. Magnetic resonance imaging of the lumbar spine in asymptomatic adults. Journal of Neuroimaging 1991; 1.1: 2-7.
10. 10. Sang JK, Tae H L, Soo M L. Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part1. Lumbar Spine J Korean Neurosurg Soc. 2013; 53: 31-38
11. 11. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994; 331: 69-73.
12. 12. Takatalo J, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Mutanen P, Sequeiros RB, Kyllönen E, Tervonen O. Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine. 2011 (12) 1; 36 (25):2180-9.
13. 13. Griffith JF, Wang YX, Antonio GE, Choi KC, Yu A, Ahuja AT. Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. Spine 2007; 32: E708-712.
14. 14. Glenn WV, Burnett K, Rauschnig W. MRI imaging of the lumbar spine. Milwaukee, WI: General Electric, 1986
15. 15. Cengiz M, Remziye S. Medical Treatment In the Low Back Pain. The Medical Journal of Kocatepe. 2010; 11: 43-54.
16. 16. Vugar N, Selim A, Emre A. Algorithm of the diagnosis and management of the low back pain. TOTBİD Dergisi 2015; 14:242–251
17. 17. Powell M.C., Szypryt P., Wilson M., Symonds E.M., Worthington B.S. Prevalence of Lumbar Disc Degeneration Observed By Magnetic Resonance in Symptomless Women. The Lancet. 1986; 328, 8520, 13(12), P1366-1367
18. 18. Oh CH, Yoon SH. Whole Spine Disc Degeneration Survey according to the Ages and Sex Using Pfirrmann Disc Degeneration Grades. Korean J Spine. 2017 (12); 14(4):148-154.
19. 19. Hu X, Chen M, Pan J, Liang L, Wang Y. Is it appropriate to measure age-related lumbar disc degeneration on the mid-sagittal MR image? A quantitative image study. Eur Spine J. 2017; (11) 17.
20. 20. Haoyu H, Yili Z, Xueqiang W,Binglin C, Yulin D,Juan Z, Xiaochen L. Correlations between lumbar neuromuscular function and pain, lumbar disability in patients with nonspecific low back pain. Medicine. 2017; 96:36 e7991.
21. 21. Dutta S, Bhave A, Patil S. Correlation of 1.5 Tesla Magnetic Resonance Imaging with Clinical and Intraoperative Findings for Lumbar Disc Herniation. Asian Spine J. 2016; (12); 10(6):1115-1121.
22. 22. Mehmet K, Aram B, Cem D, Celal A. İ. Spontan Regrese Olan Lomber Disk Hernisi: Üç Olgu Sunumu. Sinir Sistemi Cerrahisi Derg. 2014; 4(1):24-28.