Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
Spine (Phila Pa 1976). 2017 Sep 1;42(17):1283-1288. doi: 10.1097/BRS.0000000000002102.
A cross-sectional and longitudinal analysis using two different datasets.
To investigate if the number of different magnetic resonance imaging (MRI) findings present is more strongly associated with low back pain (LBP) than single MRI findings.
Most previous studies have investigated the associations between single MRI findings and back pain rather than investigating combinations of MRI findings. If different individuals have different pathoanatomic sources contributing to their pain, then combinations of MRI findings may be more strongly associated with LBP.
This study used data from two previous studies that investigated the association between single MRI findings and LBP. One study was a cross-sectional population cohort of 412 people of 40 years; the second was a longitudinal cohort of 76 people recently recovered from LBP who were followed for 12 months. The outcome for the cross-sectional study was presence of LBP during the last year. The outcome for the longitudinal study was days to recurrence of activity limiting LBP. In both datasets, we created an aggregate score of the number of different MRI findings present in each individual and assessed the relationship between this aggregate score and LBP.
The risk of LBP outcome increased with increasing numbers of different MRI findings. Compared with those with no MRI findings, those with three MRI findings were at substantially greater risk of LBP in the last year (odd ratio = 14.1; 95% confidence interval, 4.32-49.47) in the cross-sectional study, or of future recurrence of LBP (hazard ratio = 12.2; 95% confidence interval 1.26-118.21) in the longitudinal study.
The aggregate MRI score was more strongly associated with LBP outcomes than single MRI findings in both datasets. Further investigation of this approach is indicated.
使用两个不同数据集的横断面和纵向分析。
研究与下腰痛（LBP）相关的磁共振成像（MRI）表现数目是否比单一 MRI 表现更密切。
大多数既往研究仅调查了单一 MRI 表现与腰痛之间的相关性，而未研究 MRI 表现的组合。如果不同个体的疼痛有不同的病理来源，那么 MRI 表现的组合可能与 LBP 更密切相关。
本研究使用了两项先前研究的数据，这些研究调查了单一 MRI 表现与 LBP 之间的相关性。一项研究为横断面人群队列研究，共纳入 412 名 40 岁人群；第二项研究为纵向队列研究，共纳入 76 名近期 LBP 缓解的患者，随访 12 个月。横断面研究的结局为过去 1 年是否存在 LBP；纵向研究的结局为限制活动的 LBP 复发天数。在两个数据集内，我们创建了每个个体存在的不同 MRI 表现的数量的综合评分，并评估了该综合评分与 LBP 之间的关系。
随着不同 MRI 表现数量的增加，LBP 结局的风险增加。与无 MRI 表现的个体相比，横断面研究中存在 3 种 MRI 表现的个体在过去 1 年内发生 LBP 的风险显著增加（比值比 = 14.1；95%置信区间，4.32-49.47），或在纵向研究中发生 LBP 复发的风险显著增加（风险比 = 12.2；95%置信区间，1.26-118.21）。
与两个数据集的单一 MRI 表现相比，综合 MRI 评分与 LBP 结局更密切相关。进一步研究这种方法是必要的。
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