The relationships between low back pain (LBP) and abnormal findings on MRI

Abstract

The relationships between low back pain (LBP) and the abnormal findings on MRI, such as lumbar disc degeneration, disc herniation and Schmorl node were examined. One hundred twenty students in medical or nursing school (3 medical and 117 nursing students, 116 females and 4 males). Mean age of the participants was 22.0 years. Subjects responded to a low back pain questionnaire, and an MRI of the lumbar spine was taken for all subjects. Films were analyzed by four observers. The grade of disc degeneration was determined by Schneiderman’s four-grade classification and the disc herniation was evaluated by the criteria of MacNab’s classification. Lumbar disc degeneration and disc herniation were revealed and examined by MRI in 42 (41 females and 1 male) and 21 subjects (20 females and 1 male), respectively. The demonstrated disc degeneration in the group with LBP (grade 1: 15 subjects, 42%; grade 2: 6, 16%; grade 3:15, 42%) was more severe than that in the group without LBP (grade 1: 63 subjects, 75%; grade 2: 13, 15.5%; grade 3: 8, 9.5%) (p<0.05). The incidence of the disc herniation was more frequent in the group with LBP (12 subjects, 33%), compared to the group without LBP (9 subjects, 11%) (p<0.05). However, the sensitivity and specificity both of the disc degeneration and disc herniation for the LBP were not high. (disc degeneration for LBP; sensitivity 50%, specificity 81%, disc herniation for LBP; sensitivity 57%, specificity 76%). Thus, we concluded that disc degeneration and herniation might be related to LBP. However, it is difficult to distinguish between LBP caused by lumbar disc diseases or by other factors, because of the low sensitivity and specificity.