Are First-Time Episodes of Serious LBP Associated With New MRI Findings?

E. Carragee, T. Alamin, I. Cheng, T. Franklin, E. van de Haak and E Hurwitz

Magnetic resonance imagaing (MRI) is frequently used to evaluate first-time episodes of serious low back pain (LBP).  Common degenerative findings are often interpretted as recent developments and the probable anatomical cause of new symptoms.  The purpose of this study was to determine whether new and serious episodes of LBP are associated with any new and relevant findings on MRI.  The study was a prospective observational study over 5 years.  In total 200 subjects were recruited, they had a life-long history of no LBP, they also had a high risk for developing new LBP.  Baseline radiographs and MRIs were taken.  Subjects were then followed up every 6 months for 5 years.  Subjects that developed new LBP had a MRI scan done.  The baseline and the second MRI were then assessed by independent, blinded readers.The results showed that in the 5 year period 51 subjects had new, serious LBP.  Of this 51, 43 had either unchanged or showed a regression of MRI findings.  The authors concluded that MRIs within 12 weeks of serious LBP are highly unlikely to represent any new structural change.

The Spine Journal, 2006, 6(6), 624-635

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