Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment

Jensen, Tue Secher; Albert, H; Sorensen, Joan S; Manniche, Claus; Leboeuf‐Yde, Charlotte

doi:10.1016/j.jmpt.2006.12.004

Cited by 30 publications

(34 citation statements)

References 49 publications

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“…Recording the standard MRI in supine position, leakage of chemical mediators or inflammatory cytokines through annular tear, functional instability, fluctuating disc bulges, and restrictions caused by discoligament injuries are some of the explanations proposed for this weak agreement [28][29][30][31][32][33]. Furthermore, duration of symptoms could be a causative factor as Jensen et al [34] indicated that improvement of disc herniations and nerve root compromise over time did not coincide with definite recovery. However, some previous studies have shown the value of electrodiagnosis in localizing the involved root level as well as predicting surgical outcome and selecting patients who benefit from surgery [16,35,36].…”

Section: Discussionmentioning

confidence: 99%

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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Purpose The aim of this study was to evaluate the agreement of magnetic resonance imaging and electrodiagnostic studies by comparing their findings in patients with clinically suspected radiculopathy. The agreements between these two procedures and clinical findings were also examined. Methods In a 2-year cross-sectional study, a total of 114 patients with clinically suspected cervical or lumbosacral radiculopathy were included. Results The total agreements between clinical with MRI and EDX findings were 72 and 52 %, respectively while their agreements were similar in group definite (89 vs. 82 %). The agreement between EDX and MRI was 59.6 in total and 49 % with respect to clinical findings. Conclusion This study further supports that these two methods are complementary in general. It is reasonable to add EDX when there is discrepancy between MRI and clinical findings or when MRI neurologic findings are not visible.

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Section: Discussionmentioning

confidence: 99%

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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“…A diverse range of prognostic factors (demographics, physical factors, and psychological factors) has been studied in relation to persistent LBP [5]. The prognostic value of MRI findings in relation to recovery has mainly been studied in patients with sciatica in secondary care [6][7][8][9][10][11]; however, these results may differ from studies performed in patients with LBP in general practice.…”

Section: Introductionmentioning

confidence: 99%

The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study

et al. 2016

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Purpose Information on the prognostic value of MRI findings in low back pain patients in primary care is lacking. The objective of this study is to investigate the added prognostic value of baseline MRI findings over known prognostic factors for recovery at 12-month followup in patients with low back pain referred to MRI by their general practitioner. Methods Patients referred by their general practitioner for MRI of the lumbar spine were recruited at the MRI Center. The questionnaires at baseline and at 3 and 12-months follow-up included potential clinical predictors from history taking and the outcome recovery. The MRI radiology reports were scored. Analysis was performed in 3 steps: derivation of a predictive model including characteristics of the patients and back pain only (history taking), including reported MRI findings only, and the addition of reported MRI findings to the characteristics of the patients and back pain. Results At 12-months follow-up 53 % of the patients reported recovery (n = 683). Lower age, better attitude/beliefs regarding back pain, acute back pain, presence of neurological symptoms of the leg(s), and presence of non-continuous back pain were significantly associated with recovery at 12-months follow-up: area under the curve (AUC) 0.77. Addition of the MRI findings resulted in an AUC of 0.78. Conclusions At 12-months follow-up, only 53 % of these patients with low back pain referred for MRI in general practice reported recovery. Five clinic baseline characteristics were associated with recovery at 12-months followup; adding the MRI findings did not result in a stronger prediction of recovery.Keywords Low back pain Á Low back pain/diagnosis Á Magnetic resonance imaging Á Primary health care Á Outcome Á Predictive value of tests Á Area under curve Á Logistic models

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“…After adjustment for initial disability and duration of symptoms, [12];°disability \ 20 on ODI [9]; § odds ratio not calculable as a result of all participants with disc sequestrations reporting no/mild disability at followup; this association was not statistically significant when tested using Fisher's exact test (data not shown); CI = confidence interval; VAS = visual analog scale; ODI = Oswestry Disability Index; SACQ = SelfAcquired Comorbidity Questionnaire [13].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, VAS leg pain and ODI disability were dichotomized. In the absence of widely accepted criteria for defining absent/minimal sciatic pain, we dichotomized VAS leg pain as absent (\ 1) versus persistent (C 1), a threshold applied previously [12]. ODI disability scores were dichotomized at a cutoff point of 20, which defines the lowest stratum of disability originally proposed with the ODI [9] and has been used in prior studies [5,15,16].…”

Section: Discussionmentioning

confidence: 99%

Nonoperative Treatment for Lumbosacral Radiculopathy: What Factors Predict Treatment Failure?

Suri

Carlson

Rainville

2015

Clinical Orthopaedics &Amp; Related Research

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Background Prior studies of nonoperative treatment for lumbosacral radiculopathy have identified potential predictors of treatment failure, defined by persistent pain, persistent disability, lack of recovery, or subsequent surgery. However, few predictors have been replicated, with the exception of higher leg pain intensity, as a predictor of subsequent surgery.Questions/purposes We asked two research questions: (1) Does higher baseline leg pain intensity predict subsequent lumbar surgery? (2) Can other previously identified ''candidate'' predictors of nonoperative treatment failure be replicated? Methods Between January 2008 and March 2009, 154 participants with acute lumbosacral radicular pain were enrolled in a prospective database; 128 participants (83%) received nonoperative treatment and 26 (17%) received surgery over 2-year followup. Ninety-four nonoperative participants (73%) responded to followup questionnaires. We examined associations between previously identified ''candidate'' predictors and treatment failure defined as (1) subsequent surgery; (2) persistent leg pain on a visual analog scale; (3) persistent disability on the Oswestry Disability Index; or (4) participant-reported lack of recovery over 2-year followup. Confounding variables including sociodemographics, clinical factors, and imaging characteristics were evaluated using an exploratory bivariate analysis followed by a multivariate analysis. Results With the numbers available, higher baseline leg pain intensity was not an independent predictor of subsequent surgery (adjusted odds ratio [aOR], 1.22 per point of baseline leg pain; 95% confidence interval [CI], 0.98-1.53; p = 0.08). Prior low back pain (aOR, 4.79; 95% CI, 1.01-22.7; p = 0.05) and a positive straight leg raise test (aOR, 4.38; 95% CI,; p = 0.004) predicted subsequent surgery. Workers compensation claims predicted persistent leg pain (aOR, 9.04; 95% CI, 1.01-81; p = 0.05) and disability (aOR, 5.99; 95% CI, 1.09-32.7; p = 0.04). Female sex predicted persistent disability (aOR, 3.16; 95% CI, 1.03-9.69; p = 0.05) and perceived lack of recovery (aOR, 2.44; 95% CI, 1.02-5.84; p = 0.05). Conclusions Higher baseline leg pain intensity was not confirmed as a predictor of subsequent surgery. However,

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Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment

Cited by 30 publications

References 49 publications

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study

Nonoperative Treatment for Lumbosacral Radiculopathy: What Factors Predict Treatment Failure?

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