Kim M. Schindler MD, Presenter: Nothing to Disclose

Michael Terrence Modic MD, Abstract Co-Author: Nothing to Disclose

Jeffrey S. Ross MD, Abstract Co-Author: Nothing to Disclose

Nancy A. Obuchowski PhD, Abstract Co-Author: Nothing to Disclose

Paul N. Grooff MD, Abstract Co-Author: Nothing to Disclose

Michael N. Brant-Zawadzki MD, Abstract Co-Author: Nothing to Disclose

Prospective study to assess the prognostic role of MR findings in patients with LBP and Radiculopathy

246 patients with acute-onset (<3 weeks) of LBP (N= 150) and/or radiculopathy (N= 96) were recruited. H&P, demographics and QTFC data were recorded. After an MR at presentation, patients followed six weeks of conservative management. Roland function, visual pain analog, absenteeism, SF-36 Health Status Survey, SES, and FAQ questionnaires were completed at presentation, 2, 4, 6, and 8 weeks, and 6, 12, and 24 months. The percent improvement in patient function was measured using the Roland score. Improvement by 50% was considered a positive outcome. Studies were interpreted by three independent radiologists blinded to the clinical information. Characterization of altered morphology included presence or absence of HNP, nerve root impingement, central canal and foraminal stenosis, free fragments, annular tears, spondylolisthesis, endplate change and facet disease.

In a multivariable analysis of both non imaging and imaging variables, only two were statistically significant. Roland function improved 3.2 times more often among Caucasians than among minorities (p=0.001) and 2.7 times as often among patients with a herniation at baseline than among patients without a herniation (p=0.003).

In typical patients with LBP or radiculopathy, imaging does not appear to have a measurable value in terms of planning conservative management.

Schindler, K, Modic, M, Ross, J, Obuchowski, N, Grooff, P, Brant-Zawadzki, M, Prognostic Role of MR Findings in LBP and Radiculopathy.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409593.html