Amy Marie Neville, Presenter: Nothing to Disclose

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

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

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

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

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

Assess and compare the prevalence and behavior over time of altered morphology in patients with acute low back pain and radiculopathy.

246 patients with acute-onset (<3 weeks) of LBP (N= 150) and/or radiculopathy (N= 96) were recruited. H&P, demographics, Roland function and visual pain analog were recorded at presentation. 183 patients had a second MR performed at six weeks. Studies were interpreted by three independent radiologists blinded to the clinical information and temporal sequence. 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.

The degenerative disk disease findings on MR at presentation were not statistically significantly different for LBP and radiculopathy patients. The prevalence rate of herniations was 57% (95% CI: 0.49-0.65) for LBP patients and 65% (0.55-0.74) for patients with radiculopathy (p=0.217). Patients with radiculopathy were more likely to have stenosis, especially severe stenosis, and extruded disks than patients with LBP only [p=0.006]. Severe nerve root compression was more common in radiculopathy patients (p<0.001). 13% of patients had a new or enlarged herniation at 6 weeks. Herniations at presentation were reduced in size or completely resolved in 15% of LBP patients and 35% of patients with radiculopathy.

The prevalence of disk herniations in patients with LBP and radiculopathy at presentation were similar. There are significant changes in the appearance of MR studies in these populations with both regression and new herniations during a six week interval.

Neville, A, Ross, J, Modic, M, Obuchowski, N, Brant-Zawadzki, M, Grooff, P, Natural History of Morphologic Findings on MR 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/2004/4412137.html