Magnetic Resonance Findings of Acute Severe Lower Back Pain

Abstract

ObjectiveTo determine abnormal MRI findings in adults hospitalized with acute severe axial LBP.MethodSixty patients with back pain were divided into 3 groups consisting of 1) 23 adults with acute axial severe LBP who could not sit up or stand up for several days, but had not experienced previous back-related diseases or trauma (group A), 2) 19 adults who had been involved in a minor traffic accident, and had mild symptoms but not limited mobility (group B), and 3) 18 adults with LBP with radicular pain (group C)., Various MRI findings were assessed among the above 3 groups and compared as follows: disc herniation (protrusion, extrusion), lumbar disc degeneration (LDD), annular tear, high intensity zone (HIZ), and endplate changes.ResultsThe MRI findings of A group were as follows: disc herniation (87%), LDD (100%), annular tear (100%), HIZ (61%), and end plate changes (4.4%). The findings of disc herniation, annular tear, HIZ, and LDD were more prevalent in A group than in B group (p<0.01). HIZ findings were more prevalent in A group than in group B or group C (p<0.05).ConclusionPatients with acute severe axial LBP were more likely to have disc herniation, LDD, annular tear, HIZ. Among LBP groups, there was a significant association of HIZ on MRI with acute severe axial LBP.

Treatment of lumbar degenerative disc disease-associated radicular pain with culture-expanded autologous mesenchymal stem cells: a pilot study on safety and efficacy

“…This amalgamation of dense protein structures allows the annulus to withstand the gravitational and mechanical forces translated through the vertebral bodies. Disruption of the posterior annulus may be seen on MRI imaging as a high intensity zone (HIZ) which may develop into a disc protrusion [ 51 , 52 ]. Furthermore, The HIZ has been shown to harbor increased levels of tumor necrosis factor alpha [ 53 ].…”

The Factors Associated With the Successful Outcomes of Percutaneous Disc Decompression in Patients With Lumbar Herniated Nucleus Pulposus

“…Our study showed that patients with HIZ had more disability improvement than those without HIZ after PDD. Kim et al [ 22 ] reported that the incidence of HIZ was significantly higher in patients with acute severe lower back pain than in patients in the control groups. Kang et al [ 23 ] also showed HIZ has meaning when it accompanies disc protrusion.…”

Etiology and nature of intervertebral disc degeneration and its correlation with low back pain

“…Lumbar IDD versus LBP in general population. Table 3 shows the studies to date that investigated the association between lumbar IDD and LBP in the general population 11,12,38,43,60,61) . A positive association between IDD and LBP has been observed in the general population by many research groups.…”

“…We reviewed clinical papers investigating the correlation between IDD and LBP, especially in non-athletes 11,12,38,43,60,61) . All of the papers showed the same result, a significant correlation between IDD and LBP; therefore, we believe these clinical papers have several common features.…”

“…First, these studies were large population studies 12,38,43,60) . Although the studies by Samartzis et al 11) and Kim et al 61) had small sample sizes, they finely delineated the definition of LBP. In particular, to decrease the risk of recall bias in the assessment of LBP, Samartzis et al 11) consulted a family member of the participant to assess the accuracy of self-reporting.…”