The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: Baseline Data

Study Design. Prospective cohort study of randomly selected Veterans Affairs (VA) outpatients. Objective. To determine the prevalence of magnetic resonance imaging (MRI) findings in the lumbar spine among persons without current low back pain or sciatica and to examine which findings are related to age or previous back symptoms. Summary of Background Information. Previous studies of patients without low back pain have not explored the possible association of various MRI findings to past symptoms. Methods. We randomly selected an age-stratified sample of subjects without low back pain in the past 4 months from clinics at a VA hospital. We collected information on demographics, comorbidity, functional status, and quality of life. MR images were obtained using a standardized protocol through each of the five lumbar disc levels. Results. Of 148 subjects, 69 (46%) had never experienced low back pain. There were 123 subjects (83%) with moderate to severe desiccation of one or more discs, 95 (64%) with one or more bulging discs, and 83 (56%) with loss of disc height. Forty-eight subjects (32%) had at least one disc protrusion and 9 (6%) had one or more disc extrusions. Conclusion. Many MR imaging findings have a high prevalence in subjects without low back pain. These findings are therefore of limited diagnostic use. The less common findings of moderate or severe central stenosis, root compression, and extrusions are likely to be diagnostically and clinically relevant.

[1]  J. Weinreb,et al.  Prevalence of lumbosacral intervertebral disk abnormalities on MR images in pregnant and asymptomatic nonpregnant women. , 1989, Radiology.

[2]  G. Buirski,et al.  The symptomatic lumbar disc in patients with low-back pain. Magnetic resonance imaging appearances in both a symptomatic and control population. , 1993, Spine.

[3]  W. Hitselberger,et al.  Abnormal myelograms in asymptomatic patients. , 1968, Journal of neurosurgery.

[4]  M. Greenwood.  An Introduction to Medical Statistics , 1932, Nature.

[5]  M. C. Powell,et al.  PREVALENCE OF LUMBAR DISC DEGENERATION OBSERVED BY MAGNETIC RESONANCE IN SYMPTOMLESS WOMEN , 1986, The Lancet.

[6]  Marjukka Laine,et al.  Low Back Pain in the Young A Prospective Three‐Year Follow‐up Study of Subjects With and Without Low Back Pain , 1995, Spine.

[7]  R. Leclaire,et al.  A Cross‐sectional Study Comparing the Oswestry and Roland‐Morris Functional Disability Scales in Two Populations of Patients With Low Back Pain of Different Levels of Severity , 1997, Spine.

[8]  J. Wilberger,et al.  Syndrome of the incidental herniated lumbar disc. , 1983, Journal of neurosurgery.

[9]  R. Jackson,et al.  The Neuroradiographic Diagnosis of Lumbar Herniated Nucleus Pulposus: II: A Comparison of Computed Tomography (CT), Myelography, CT-Myelography, and Magnetic Resonance Imaging , 1989, Spine.

[10]  Nicholas,et al.  Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. , 1990, The Journal of bone and joint surgery. American volume.

[11]  D. L. Mcrae.  Asymptomatic intervertebral disc protrusions. , 1956, Acta radiologica.

[12]  V. Dabbs,et al.  Correlation between disc height narrowing and low-back pain. , 1990, Spine.

[13]  C. Bartolozzi,et al.  [The incidence of disk changes in volleyball players. The magnetic resonance findings]. , 1991, La Radiologia medica.

[14]  B. Worthington,et al.  The Prevalence of Disc Degeneration Associated with Neural Arch Defects of the Lumbar Spine Assessed by Magnetic Resonance Imaging , 1989, Spine.

[15]  J. Burns,et al.  Prevalence and significance of spinal disc abnormalities in an asymptomatic acceleration subject panel. , 1996, Aviation, space, and environmental medicine.

[16]  N. Patronas,et al.  A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. , 1984, Spine.

[17]  N. Bogduk,et al.  High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. , 1992, The British journal of radiology.

[18]  M. Roland,et al.  A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. , 1983, Spine.

[19]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[20]  H. Paajanen,et al.  Magnetic Resonance Study of Disc Degeneration in Young Low-Back Pain Patients , 1989, Spine.

[21]  H. Brenner,et al.  Dependence of Weighted Kappa Coefficients on the Number of Categories , 1996, Epidemiology.

[22]  J. S. Barr,et al.  脊椎管を侵す椎間板のヘルニア(Rupture of the Intervertebral Disc with Involvement of the Spinal Canal) , 1934 .

[23]  S Tola,et al.  Low-Back Pain and Occupation: A Cross-Sectional Questionnaire Study of Men in Machine Operating, Dynamic Physical Work, and Sedentary Work , 1989, Spine.

[24]  N. Obuchowski,et al.  Magnetic Resonance Imaging of the lumbar spine in people without back pain , 2017, AL-QADISIYAH MEDICAL JOURNAL.

[25]  N. Semmer,et al.  The Diagnostic Accuracy of Magnetic Resonance Imaging, Work Perception, and Psychosocial Factors in Identifying Symptomatic Disc Herniations , 1995, Spine.

[26]  M Kormano,et al.  Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. , 1993, Spine.

[27]  D. Singer,et al.  Assessing Health‐Related Quality of Life in Patients With Sciatica , 1995, Spine.

[28]  V. Mooney,et al.  Presidential Address International Society for the Study of the Lumbar Spine Dallas, 1986: Where Is the Pain Coming From? , 1987, Spine.

[29]  M. Modic,et al.  Imaging of degenerative disk disease. , 1988, Radiology.

[30]  M. Zanetti,et al.  MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. , 1998, Radiology.

[31]  M. Osteaux,et al.  Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. , 1998, Radiology.

[32]  G. Breton,et al.  Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. , 1999, Spine.

[33]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[34]  R. Kreis,et al.  Tissue characterization of symptomatic and asymptomatic disc herniations by quantitative magnetic resonance imaging , 1997, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[35]  P. Renton,et al.  The Value of Lumbar Spine Magnetic Resonance Imaging in the Demonstration of Anular Tears , 1998, Spine.

[36]  M. Janssen,et al.  Lumbar herniated disk disease: comparison of MRI, myelography, and post-myelographic CT scan with surgical findings. , 1994, Orthopedics.

[37]  J. Salminen,et al.  Low-back pain and disk degeneration in children: a case-control MR imaging study. , 1991, Radiology.