TY - JOUR
T1 - The Association Between Different Trajectories of Low Back Pain and Degenerative Imaging Findings in Young Adult Participants Within The Raine Study
AU - Smith, Anne
AU - Hancock, Mark
AU - O’Hanlon, Susan
AU - Krieser, Michael
AU - O’Sullivan, Peter
AU - Cicuttini, Flavia
AU - Straker, Leon
AU - Adler, Brendan
AU - Wang, YuanYuan
AU - Karppinen, Jaro
AU - Samartzis, Dino
AU - Beales, Darren
AU - Coenen, Pieter
AU - Kent, Peter
N1 - Funding Information: The core management of the Raine Study is funded by The University of Western Australia, Curtin University, Telethon Kids Institute, Women and Infants Research Foundation, Edith Cowan University, Murdoch University, The University of Notre Dame Australia and the Raine Medical Research Foundation. The Raine Study Gen2–22-year follow-up was funded by NHMRC project grants 1027449, 1044840, and 1021858. Funding was also generously provided by Safe Work Australia. The MRI scans of Raine Study Gen2 participants at age 27years performed for this study was funded by a grant from the Western Australian Department of Health. Publisher Copyright: © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Study Design. Case-control study. Objective. Investigate the association between lumbar spine magnetic resonance imaging (MRI) findings and 5-year trajectories of low back pain (LBP) in young Australian adults. Summary of Background Data. The association between lumbar spine imaging findings and LBP remains unclear due to important limitations of previous research, such as a lack of clearly defined LBP phenotypes and inadequate controlling for age, which may substantially affect the association. Methods. Seventy-eight ‘‘case’’ participants with a previously identified ‘‘consistent high disabling LBP’’ trajectory from age 17 to 22 years and 78 ‘‘control’’ participants from a trajectory with consistently low LBP over the same time period, matched for sex, body mass index, physical activity levels, and work physical demands, were identified from Gen2 Raine Study participants. At age 27, participants underwent a standardized lumbar MRI scan, from which 14 specific MRI phenotypes were identified. Primary analyses used unconditional logistic regression, adjusting for covariates used in the matching process, to investigate the relationship between presence of each imaging finding and being a case or control. Secondary analyses explored those relationships based on the number of spinal levels with each MRI finding. Results. The odds for being a case compared with a control were higher in those with disc degeneration (Pfirrmann grade ≥ 3; OR = 3.21, 95% CI: 1.60 – 6.44; P = 0.001) or those with a herniation (OR = 1.90, 95% CI: 0.96 – 3.74; P – 0.065). We also found that the association became substantially stronger when either disc degeneration or herniation was present at two or more spinal levels (OR = 5.56, 95% CI: 1.97 – 15.70; P = 0.001, and OR = 5.85, 95% CI: 1.54 – 22.25; P = 0.009, respectively). The other investigated MRI findings were not associated with greater odds of being a case. Conclusion. Lumbar disc degeneration and herniation may be important contributors to disabling LBP in young adults. Further investigation of their potential prognostic and causal roles is indicated.
AB - Study Design. Case-control study. Objective. Investigate the association between lumbar spine magnetic resonance imaging (MRI) findings and 5-year trajectories of low back pain (LBP) in young Australian adults. Summary of Background Data. The association between lumbar spine imaging findings and LBP remains unclear due to important limitations of previous research, such as a lack of clearly defined LBP phenotypes and inadequate controlling for age, which may substantially affect the association. Methods. Seventy-eight ‘‘case’’ participants with a previously identified ‘‘consistent high disabling LBP’’ trajectory from age 17 to 22 years and 78 ‘‘control’’ participants from a trajectory with consistently low LBP over the same time period, matched for sex, body mass index, physical activity levels, and work physical demands, were identified from Gen2 Raine Study participants. At age 27, participants underwent a standardized lumbar MRI scan, from which 14 specific MRI phenotypes were identified. Primary analyses used unconditional logistic regression, adjusting for covariates used in the matching process, to investigate the relationship between presence of each imaging finding and being a case or control. Secondary analyses explored those relationships based on the number of spinal levels with each MRI finding. Results. The odds for being a case compared with a control were higher in those with disc degeneration (Pfirrmann grade ≥ 3; OR = 3.21, 95% CI: 1.60 – 6.44; P = 0.001) or those with a herniation (OR = 1.90, 95% CI: 0.96 – 3.74; P – 0.065). We also found that the association became substantially stronger when either disc degeneration or herniation was present at two or more spinal levels (OR = 5.56, 95% CI: 1.97 – 15.70; P = 0.001, and OR = 5.85, 95% CI: 1.54 – 22.25; P = 0.009, respectively). The other investigated MRI findings were not associated with greater odds of being a case. Conclusion. Lumbar disc degeneration and herniation may be important contributors to disabling LBP in young adults. Further investigation of their potential prognostic and causal roles is indicated.
KW - Diagnosis
KW - Disc degeneration
KW - Low back pain
KW - Magnetic resonance imaging
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85123296792&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34269758
U2 - https://doi.org/10.1097/BRS.0000000000004171
DO - https://doi.org/10.1097/BRS.0000000000004171
M3 - Article
C2 - 34269758
SN - 0362-2436
VL - 47
SP - 269
EP - 276
JO - SPINE
JF - SPINE
IS - 3
ER -