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Article: Degenerative magnetic resonance imaging changes in patients with chronic low back pain: A systematic review

TitleDegenerative magnetic resonance imaging changes in patients with chronic low back pain: A systematic review
Authors
Keywordsassociation
chronic low back pain
magnetic resonance imaging
MRI
prevalence
surgery
treatment
Issue Date2011
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2011, v. 36 n. 21 SUPPL., p. S43-S53 How to Cite?
AbstractStudy Design.: Systematic review. Objective.: To systematically search for critically appraise and summarize studies that (1) evaluated the association between degenerative magnetic resonance imaging (MRI) changes and chronic low back pain (CLBP) and (2) compared surgical and nonsurgical treatment of these degenerative MRI changes. Summary of Background DATA.: The role of routine MRI in patients with CLBP is unclear. It is also uncertain whether or not surgical treatment of degenerative MRI changes results in alleviation of back pain. Methods.: Systematic literature searches were conducted in PubMed for studies published through March 1, 2011. To evaluate whether MRI degenerative changes are associated with CLBP, studies that were designed to compare the prevalence of MRI changes among subjects with and without CLBP were sought. The prevalence odds ratio was used to compare the odds of degenerative MRI findings in subjects with CLBP to the odds of such findings among those without CLBP. To evaluate whether surgical treatment of degenerative MRI changes is associated with different outcomes compared with nonsurgical treatment, comparative studies were sought. The GRADE system as applied to describe the strength of the overall body of evidence. Results.: Regarding the association of degenerative changes on MRI and CLBP, five studies were included, all of which were cross-sectional in design. On the basis of these studies, a statistically significant association was found in all but one study regarding the presence of disc degeneration and CLBP (odds ratio range: 1.8-2.8). The overall strength of evidence across studies was considered to be insufficient, however. No comparative studies of surgical versus nonsurgical treatment of degenerative MRI changes were identified. Conclusion.: Although there may be an association between degenerative MRI changes and CLBP, it is unknown if these estimates accurately represent the association given the quality of included studies, lack of a direct link between degenerative MRI changes and CLBP, and heterogeneity across studies. Thus, a strong recommendation against the routine use of MRI for CLBP evaluation is made. Since there are no data evaluating the efficacy of the surgical treatment of degenerative MRI changes, a strong recommendation is made against the surgical treatment of CLBP based solely upon degenerative MRI changes. Clinical Recommendations.: © 2011, Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/137443
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
Funding AgencyGrant Number
AOSpine of North America
Funding Information:

AOSpine of North America supported this work.

References

 

DC FieldValueLanguage
dc.contributor.authorChou, Den_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorBellabarba, Cen_HK
dc.contributor.authorPatel, Aen_HK
dc.contributor.authorLuk, KDKen_HK
dc.contributor.authorKisser, JMSen_HK
dc.contributor.authorSkelly, ACen_HK
dc.date.accessioned2011-08-26T14:25:14Z-
dc.date.available2011-08-26T14:25:14Z-
dc.date.issued2011en_HK
dc.identifier.citationSpine, 2011, v. 36 n. 21 SUPPL., p. S43-S53en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137443-
dc.description.abstractStudy Design.: Systematic review. Objective.: To systematically search for critically appraise and summarize studies that (1) evaluated the association between degenerative magnetic resonance imaging (MRI) changes and chronic low back pain (CLBP) and (2) compared surgical and nonsurgical treatment of these degenerative MRI changes. Summary of Background DATA.: The role of routine MRI in patients with CLBP is unclear. It is also uncertain whether or not surgical treatment of degenerative MRI changes results in alleviation of back pain. Methods.: Systematic literature searches were conducted in PubMed for studies published through March 1, 2011. To evaluate whether MRI degenerative changes are associated with CLBP, studies that were designed to compare the prevalence of MRI changes among subjects with and without CLBP were sought. The prevalence odds ratio was used to compare the odds of degenerative MRI findings in subjects with CLBP to the odds of such findings among those without CLBP. To evaluate whether surgical treatment of degenerative MRI changes is associated with different outcomes compared with nonsurgical treatment, comparative studies were sought. The GRADE system as applied to describe the strength of the overall body of evidence. Results.: Regarding the association of degenerative changes on MRI and CLBP, five studies were included, all of which were cross-sectional in design. On the basis of these studies, a statistically significant association was found in all but one study regarding the presence of disc degeneration and CLBP (odds ratio range: 1.8-2.8). The overall strength of evidence across studies was considered to be insufficient, however. No comparative studies of surgical versus nonsurgical treatment of degenerative MRI changes were identified. Conclusion.: Although there may be an association between degenerative MRI changes and CLBP, it is unknown if these estimates accurately represent the association given the quality of included studies, lack of a direct link between degenerative MRI changes and CLBP, and heterogeneity across studies. Thus, a strong recommendation against the routine use of MRI for CLBP evaluation is made. Since there are no data evaluating the efficacy of the surgical treatment of degenerative MRI changes, a strong recommendation is made against the surgical treatment of CLBP based solely upon degenerative MRI changes. Clinical Recommendations.: © 2011, Lippincott Williams & Wilkins.en_HK
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectassociationen_HK
dc.subjectchronic low back painen_HK
dc.subjectmagnetic resonance imagingen_HK
dc.subjectMRIen_HK
dc.subjectprevalenceen_HK
dc.subjectsurgeryen_HK
dc.subjecttreatmenten_HK
dc.titleDegenerative magnetic resonance imaging changes in patients with chronic low back pain: A systematic reviewen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=36, Suppl. 21S&spage=S43&epage=S53&date=2011&atitle=Degenerative+magnetic+resonance+imaging+changes+in+patients+with+chronic+low+back+pain:+a+systematic+review-
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e31822ef700en_HK
dc.identifier.pmid21952189-
dc.identifier.scopuseid_2-s2.0-80053405229en_HK
dc.identifier.hkuros189126en_US
dc.identifier.hkuros207336-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80053405229&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume36en_HK
dc.identifier.issue21 SUPPL.en_HK
dc.identifier.spageS43en_HK
dc.identifier.epageS53en_HK
dc.identifier.isiWOS:000296067700004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChou, D=12768245300en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridBellabarba, C=7004108256en_HK
dc.identifier.scopusauthoridPatel, A=7403524990en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.scopusauthoridKisser, JMS=53865175900en_HK
dc.identifier.scopusauthoridSkelly, AC=55328675400en_HK

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