Orthopedics (71)

Abstract

Natural history of individuals with asymptomatic disc abnormalities in magnetic resonance imaging: predictors of low back pain‐related medical consultation and work capacity. (University of Zurich, Zurich, Switzerland) Spine 2000;25:1484–1492.This prospective study involved 46 asymptomatic individuals who had a high rate of disc herniations (73%) that were observed for an average of 5 years. Four classes of variable were assessed at baseline and follow‐up. Disc herniations and neural compromise did not significantly worsen at follow‐up, whereas disc degeneration progresses in 17 individuals (41.5%). Minor episodes of low back pain occurred in 19 individuals (41.3%), 6 of whom had to seek medical treatment and 5 of whom had to stop work temporarily. The requirement for low back pain‐related medical consultation was predicted with high accuracy by listlessness, job satisfaction, and working in shifts (P < 0.001). Work capacity was best predicted by physical job characteristics, job disaffection, and working in shifts (P < 0.001). Conclude that physical job characteristics and psychological aspects of work were more powerful than magnetic resonance imaging‐identified disc abnormalities in predicting the need for low back pain‐related medical consultation and the resultant work incapacity. However, the conclusions are still preliminary, and replication of the findings in larger and more representative study samples is needed.