Regression between MR findings of lumbar elements and chronic low back pain

Abstract

Objective To investigate the relationship between the MR findings of lumbar elements and chronic low back pain(CLBP). Methods The patients underwent lumbar MRI examinations and sent for a questionnaires of low back pain (LBP). Among them, 139 patients whose questionnaires illustrated with CLBP were enrolled. The enrolled patients included 68 patients with nerve roots compression and 71 patients without. Meanwhile, 198 hospital staffs underwent lumbar MRI examinations and were sentfor a LBP questionnaire.Among them, 62 patients without LBP and nerve roots compression were enrolled. Categorical regression was used to analyze the relationship between MR findings and CLBP. The MR findings included nerve roots compression, average disk degeneration scores(ADD), high-intensity zones (HIZ), Schmorlnodes, Modic Ⅰ change, average facet joints degeneration scores(AZZ), facet joint effusion, high T2 signal in interspinous ligament and subcutaneousparaspinal muscles edema. The regression model was used to analyze the MR imaging and CLBP. Results The regression model was statistically significant (F=9.478,P<0.01). All predictors yielded an adjusted value was 0.446. Among all predictors, nerve roots compression, ADD, AZZ, subcutaneous or paraspinal muscles edema were statistically associated with the VAS degree (P<0.05). The sum of the importance of the four predictors above was 0.983. The quantification of predicted VAS degree increased as ADD level increased. The quantification of predicted VAS degree increased to the top at the 2 AZZ level and then decreased. Nerve roots compression and Subcutaneous or paraspinal muscles edema yielded higher quantification of predicted VAS degree level. Conclusion ADD, AZZ, subcutaneousparaspinal muscles edema were probably associated with CLBP degree after adjusting for nerve roots compression. Key words: Low back pain; Magnetic resonance imaging; Visual analogue scale