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The relationship between findings on magnetic resonance imaging and previous history of low back pain

Authors Tonosu J, Oka H, Matsudaira K, Higashikawa A, Okazaki H, Tanaka S

Received 14 September 2016

Accepted for publication 24 November 2016

Published 29 December 2016 Volume 2017:10 Pages 47—52

DOI https://doi.org/10.2147/JPR.S122380

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Juichi Tonosu,1 Hiroyuki Oka,2 Ko Matsudaira,2 Akiro Higashikawa,1 Hiroshi Okazaki,1 Sakae Tanaka3

1Department of Orthopedic Surgery, Kanto Rosai Hospital, Kawasaki, 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, 3Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

Abstract: The objective of this study was to evaluate the relationship between magnetic resonance imaging (MRI) findings and previous low back pain (LBP) in participants without current LBP. Current LBP was defined as LBP during the past month. Previous LBP was defined as a history of medical consultation for LBP. Ninety-one participants without current LBP were included. Sagittal T2-weighted MRI was used to assess the intervertebral space from T12/L1 to L5/S1. These images were classified into five grades based on the Pfirrmann grading system. Furthermore, we evaluated the presence of disk bulging, high-intensity zone, and spondylolisthesis. We compared the MRI findings between groups with (27 participants) and without (64 participants) previous LBP without current LBP. Intraobserver and interobserver kappa values were evaluated. Participants had an average age of 34.9 years; 47 were female and 44 were male; and their average body mass index was 21.8 kg/m2. Compared to the group of participants without previous LBP, the group of participants with previous LBP had a significantly higher incidence of disk degeneration such as a Pfirrmann grade ≥3, disk bulging, and high-intensity zone in the analyses adjusted by age and sex. There were no significant differences in spondylolisthesis between the groups. An odds ratio of >10 was only found for Pfirrmann grade ≥3, ie, a Pfirrmann grade ≥3 was strongly associated with a history of previous LBP in participants without current LBP.

Keywords: disk bulging, low back pain, magnetic resonance imaging, MRI, Pfirrmann grading, previous history, high-intensity zone

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