Tuesday, August 31, 2010

Is Asymptomatic Lumbar Spine Pathology Predictive of Future Low Back Pain?

This study investigated whether the findings on the scans of the lumbar spine that had been made in 1989 predicted the development of low-back pain in a group of 67 asymptomatic individuals with no history of back pain. In 1989, 21 subjects (31%) had an identifiable abnormality of a disc or of the spinal canal.

A questionnaire concerning the development and duration of low-back pain over a 7 year period was sent to the 67 asymptomatic individuals from the 1989 study. A total of 50 subjects completed and returned the questionnaire. A repeat magnetic resonance scan was made for 31 of these subjects.

Of the 50 subjects who returned the questionnaire, 29 (58%) had no back pain. Low-back pain developed in 21 subjects during the 7 year study period. The 1989 scans of these subjects demonstrated normal findings in twelve, a herniated disc in five, stenosis in three, and moderate disc degeneration in one. Eight individuals had radiating leg pain; four of them had had normal findings on the original scans, two had had spinal stenosis, one had had a disc protrusion, and one had had a disc extrusion. In general, repeat magnetic resonance imaging scans revealed a greater frequency of disc herniation, bulging, degeneration, and spinal stenosis than did the original scans.

The findings on magnetic resonance scans were not predictive of the development or duration of low-back pain. Individuals with the longest duration of low-back pain did not have the greatest degree of anatomical abnormality on the original 1989 scans. Clinical correlation is essential to determine the importance of abnormalities on magnetic resonance images.

Source: http://thepainsource.com/archives/399

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic

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