Abstract
ABSTRACT Objective To evaluate whether vertebral endplate signal changes (VESCs) influence the prognosis of patients submitted to conservative or surgical treatment for low back pain and lumbosciatica. Methods Study with 241 patients who underwent conservative treatment, infiltration or surgery with 12 months of follow-up. They were evaluated for pain by the Visual Analog Scale for Pain (VAS), for function by the Roland Morris questionnaire and for quality of life by the EuroQoI5 (EQ-5D). Results The VESCs did not have a significant effect on the treatment responses for the VAS (F = 0.03; P = 0.97), Roland Morris (F = 0.51; P = 0.60) and EQ-5D (F = 2.67; P = 0.07) variables, nor was there any interaction between VESC and treatment for VAS (F = 2.15; P = 0.08), Roland Morris (F = 1.55; P = 0.19) and EQ-5D (F = 2.15; P = 0.08). There was a significant effect for all treatments, however, the effect of the surgical procedure was superior when compared to the others (P <0.001). The VESC frequency was 48.33% for type 0, 29.17% for type I and 22.50% for type II. Conclusions The presence of VESC and its different types is not associated with a worse prognosis, nor was a higher prevalence of VESC observed in the patients with low back pain and lumbosciatica. Level of Evidence II; Retrospective cohort study.
Highlights
Low back pain is one of the most common complaints in the emergency room
The presence of vertebral endplate signal changes (VESCs) and its different types is not associated with a worse prognosis, nor was a higher prevalence of VESC observed in the patients with low back pain and lumbosciatica
The objective of this study is to evaluate whether changes of the vertebral endplate signal influence the prognosis of patients with low back pain and lumbosciatica submitted to conservative treatment or surgery and to try to observe what type of alteration is the most common in each group of patients
Summary
Low back pain is one of the most common complaints in the emergency room. About 70% to 85% of the population experiences low back pain at least once in their life, with an annual prevalence of 15% to 45%.1 Most cases of low back pain have a good prognosis with improved symptoms in around 8 weeks and with a recovery rate of 95% in a few months. Most cases of low back pain have a good prognosis with improved symptoms in around 8 weeks and with a recovery rate of 95% in a few months. It occurs most often in adults, distributed between men and women.[2]. The objective of this study is to evaluate whether changes of the vertebral endplate signal (observed in MR using the Modic classification) influence the prognosis of patients with low back pain and lumbosciatica submitted to conservative treatment or surgery and to try to observe what type of alteration is the most common in each group of patients
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