Danish Medical Bulletin - No. 1. February 2005. Vol. 52 Page 30.

ABSTRACT OF PhD DISSERTATION

Low back pain in relation to lumbar spine abnormalities
as identified by
magnetic resonance imaging

Per Kjær, PT, MSc

PDF

This PhD dissertation was accepted by the Faculty of Health Sciences of the University of Southern Denmark, and defended on January 13, 2005.

Official opponents: Kirsten Ohm Kyvik, Finn Biering-Sørensen and Henrik S. Thomsen, Denmark.

Correspondence: Per Kjær, The Back Research Center, Backcenter Funen, Lindevej 5, 5750 Ringe, Denmark. E-mail: pkrj@shf.fyns-amt.dk

Dan Med Bull 2005;52:30.

ABSTRACT

This PhD dissertation is based upon the study "The Backs of Funen - what is the source of their pain?", which was carried out at the Back Research Center, Ringe, Denmark. The basis of this thesis is the lack of knowledge regarding the clinical relevance of MRI findings in relation to low back pain. The aim of the study was to clarify the incidence of MRI findings and their associations to low back pain in 13- and 40-year old individuals from the general population.

The study involved 412 40-year-olds and 439 13-year-old children from Funen. All participants underwent an MR scan. Low back pain was determined with questionnaires/interviews.

Low back pain "in the last month" was reported by 42% of the adults and 22% of the children, "pain during the previous year" by 69% of the adults and 41% of the children. Twenty eight per cent of the adults and 8% of the children had sought care for their symptoms.

Considerable degenerative discal changes were seen in approximately 50% of the adults and 20% of the children. Disc herniations were found in 25% and 3% of children and adults, respectively, while endplate changes were seen in 30% of the adults and 6% of the children. Modic type changes were found in 22% of the adults and spondylolisthesis in 3% in both age groups.

In adults, the MRI findings with the strongest associations to low back pain were Modic changes, spondylolisthesis, and severe fat infiltration in the deep spinal muscles. Degenerative discal changes were moderately associated with LBP. As regards the children, degenerative findings in the discs and endplate irregularities were most strongly associated with low back pain. Disc herniations and spondylolisthesis were strongly associated with seeking care.

Based upon the findings of our study, the greatest clinical relevance of MRI findings in relation to low back pain in adults appears to be Modic type changes. Endplate changes, degeneration of the intervertebral discs, and disc herniations are relevant in children, whereas spondylolisthesis is a relevant finding in both children and adults. Definitive conclusions regarding the clinical relevance of MRI findings will require follow-up studies.
DANISH MEDICAL BULLETIN
The Danish Medical Bulletin reserves the right to store and publish articles (texts and illustra-tions), electronically too, eg on CD-ROM and the Internet. All rights reserved, ie prohibition against publication of texts and illustrations from the Danish Medical Bulletin. Rights can only be obtained by written acceptance from the author and editors and by quoting the Danish Medical Bulletin as source. Quotations of information from the Danish Medical Bulletin may not be published until after the publication of the issue in question and quotation of the source.