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An Epidemiologic Study of MRI and Low Back Pain in 13-Year-Old Children

Kjaer, Per, PT, MSc, PhD; Leboeuf-Yde, Charlotte, DC, MPH, PhD; Sorensen, Joan Solgaard, MD; Bendix, Tom, MD, PhD

doi: 10.1097/01.brs.0000157424.72598.ec
Diagnostics
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Study Design. Cross-sectional cohort study of a general population.

Objective. To describe associations between “abnormal” lumbar magnetic resonance imaging (MRI) findings and low back pain (LBP) in 13-year old children.

Summary and Background Data. Very little is known about the distribution of lumbar MRI findings and how they are associated with LBP in youngsters.

Methods. Disc abnormalities, as well as nerve root compromise, endplate changes, and anterolisthesis were identified from MRI studies of 439 children. LBP was identified from structured interviews. Associations are presented as odds ratios (OR).

Results. Signs of disc degeneration were noted in approximately 1/3 of the subjects. Reduced signal intensity and irregular nucleus shape in the upper 3 lumbar discs were significantly associated with LBP within the last month (OR, 2.5–3.6), whereas reduced signal intensity and disc protrusion at L5–NS1 were associated with seeking care (OR, 2.8 and 7.7, respectively). Endplate changes in relation to the L3 discs were associated with LBP month and seeking care (OR, between 9.7 and 22.2). Anterolisthesis at L5 was associated with seeking care (OR, 4.3). There were obvious differences between genders: degenerative disc changes in the upper lumbar spine were more strongly associated with LBP in boys, while disc abnormalities in the lower lumbar spine were more strongly associated with seeking care in girls.

Conclusions. In children, degenerative disc findings are relatively common, and some are associated with LBP. There appears to be a gender difference. Disc protrusions, endplate changes, and anterolisthesis in the lumbar spine were strongly associated with seeking care for LBP.

In an epidemiological study of 439, 13-year-old children, lumbar magnetic resonance imaging findings were rather frequent. Moderate-to-strong and some gender-specific associations with low back pain, and seeking care were noted for degenerative disc findings, disc protrusions, endplate changes, and anterolisthesis.

From The Back Research Center, Backcenter Funen and University of Southern Denmark, Lindevej, Denmark.

Acknowledgment date: February 22, 2004. First revision date: May 5, 2004. Acceptance date: May 5, 2004.

Supported by The Industrial Insurance Company [Top Danmark].

The manuscript submitted does not contain information about medical device(s)/drug(s).

Corporate/Industry, Institutional, and Foundation funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Per Kjaer, PT, MSc, PhD, The Back Research Center, Backcenter Funen and University of Southern Denmark, Lindevej 5, DK-5750 Ringe, Denmark; E-mail: pkrj@shf.fyns-amt.dk.

© 2005 Lippincott Williams & Wilkins, Inc.