| TITLE: | Magnetic resonance
imaging of the lumbar spine in people without back pain [see comments]
| AUTHORS:
| Jensen MC; Brant-Zawadzki
MN; Obuchowski N; Modic MT; Malkasian D; Ross JS
| AUTHOR AFFILIATION:
| Hoag Memorial
Hospital, Newport Beach, Calif. 92663.
| SOURCE:
| N Engl J Med 1994
Jul 14;331(2):69-73
| CITATION IDS:
| PMID: 8208267 UI:
94268526
| COMMENT:
| Comment in: N Engl J
Med 1994 Jul 14;331(2):115-6 | Comment in: N Engl J Med 1994 Dec 1;331(22):1525 Comment in: N Engl J Med 1994 Dec 1;331(22):1525; discussion 1526 Comment in: N Engl J Med 1994 Dec 1;331(22):1525-6 Comment in: N Engl J Med 1994 Dec 1;331(22):1526 ABSTRACT:
| BACKGROUND. The
relation between abnormalities in the lumbar spine and low back pain is
controversial. We examined the prevalence of abnormal findings on magnetic
resonance imaging (MRI) scans of the lumbar spine in people without back
pain. METHODS. We performed MRI examinations on 98 asymptomatic people.
The scans were read independently by two neuroradiologists who did not
know the clinical status of the subjects. To reduce the possibility of
bias in interpreting the studies, abnormal MRI scans from 27 people with
back pain were mixed randomly with the scans from the asymptomatic people.
We used the following standardized terms to classify the five
intervertebral disks in the lumbosacral spine: normal, bulge
(circumferential symmetric extension of the disk beyond the interspace),
protrusion (focal or asymmetric extension of the disk beyond the
interspace), and extrusion (more extreme extension of the disk beyond the
interspace). Nonintervertebral disk abnormalities, such as facet
arthropathy, were also documented. RESULTS. Thirty-six percent of the 98
asymptomatic subjects had normal disks at all levels. With the results of
the two readings averaged, 52 percent of the subjects had a bulge at at
least one level, 27 percent had a protrusion, and 1 percent had an
extrusion. Thirty-eight percent had an abnormality of more than one
intervertebral disk. The prevalence of bulges, but not of protrusions,
increased with age. The most common nonintervertebral disk abnormalities
were Schmorl's nodes (herniation of the disk into the vertebral-body end
plate), found in 19 percent of the subjects; annular defects (disruption
of the outer fibrous ring of the disk), in 14 percent; and facet
arthropathy (degenerative disease of the posterior articular processes of
the vertebrae), in 8 percent. The findings were similar in men and women.
CONCLUSIONS. On MRI examination of the lumbar spine, many people without
back pain have disk bulges or protrusions but not extrusions. Given the
high prevalence of these findings and of back pain, the discovery by MRI
of bulges or protrusions in people with low back pain may frequently be
coincidental.
| MAIN MESH HEADINGS:
| *Back Pain | Intervertebral Disk/*pathology Intervertebral Disk Displacement/*diagnosis Lumbar Vertebrae/*pathology *Magnetic Resonance Imaging ADDITIONAL MESH
HEADINGS:
| Adult | Aged Aged, 80 and over Back Pain/etiology Female Human Intervertebral Disk Displacement/complications Male Middle Age Prevalence Sacrum/pathology Support, Non-U.S. Gov't 1994/07 1994/14 00:00 PUBLICATION TYPES:
| JOURNAL ARTICLE
| LANGUAGES:
| Eng
| |
|---|
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