Correlation of Pain With Objective Quantification of Magnetic Resonance Images in Older Adults With Chronic Low Back Pain

Abstract

Study Design Cross sectional study. Objective The goal of this study is to identify relationships between objectively measured and subjectively scored parameters and reported pain. Summary of Background Data Studies have demonstrated the unreliability of MRI based parameters to identify pathological pain generators of chronic low back pain patients, but they were based on visual inspection and subjective assessment of lumbar disc features. Advancements in computer image analysis provide objective measurements of lumbar disc features. Methods Two radiologists evaluated 39 axial and sagittal T1 and T2 weighted MRI images of chronic axial low back pain patients (age > 65 years) and graded 4 subjective lumbar disc parameters (T2 signal intensity, nucleus shape, Modic changes, and osteophyte formation) whose sum is the cumulative MRI score. Objective parameter, MRIindex, was calculated as the product of the measured lumbar disc area and total disc MRI signal intensity. Discs were sorted from least to most degenerated relative to each parameter. Pearson correlation coefficient and multiple linear regression analysis were performed between the reported pain score and each parameter. Results The most and least degenerated discs in each patient, as assessed by MRIindex, had the highest negative and positive correlation coefficient and regression weight contribution respectively. All subjective parameters had low correlation coefficients and regression goodness of fit. Conclusion Although limited by small sample size, the objective parameter, MRIindex, can be a potential imaging biomarker used to identify possible pain generators. This study presents a potential new application of MR imaging in identifying pain generators of chronic low back pain patients.

The Long-term Clinical Effect of Minimal-Invasive TLIF Technique in 1-Segment Lumbar Disease

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“…Previous studies have demonstrated associations between Modic changes and low back symptoms 20 , 21 and between Modic changes and lumbar spine kinematics. 19 , 22 – 24 To the best of our knowledge, no previous study has shown a relationship between Modic changes and axial neck pain in CK.…”

Oswestry Disability Index scores correlate with MRI measurements in degenerating intervertebral discs and endplates

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