Ann Rehabil Med.  2012 Feb;36(1):47-54. 10.5535/arm.2012.36.1.47.

Magnetic Resonance Findings of Acute Severe Lower Back Pain

• Kim SY
• Lee IS
• Kim BR
• Lim JH
• Lee J
• Koh SE
• Kim SB
• Park SL

• KMID: 2266780
• DOI: http://doi.org/10.5535/arm.2012.36.1.47

Abstract

OBJECTIVE
To determine abnormal MRI findings in adults hospitalized with acute severe axial LBP. METHOD: Sixty patients with back pain were divided into 3 groups consisting of 1) 23 adults with acute axial severe LBP who could not sit up or stand up for several days, but had not experienced previous back-related diseases or trauma (group A), 2) 19 adults who had been involved in a minor traffic accident, and had mild symptoms but not limited mobility (group B), and 3) 18 adults with LBP with radicular pain (group C)., Various MRI findings were assessed among the above 3 groups and compared as follows: disc herniation (protrusion, extrusion), lumbar disc degeneration (LDD), annular tear, high intensity zone (HIZ), and endplate changes.
RESULTS
The MRI findings of A group were as follows: disc herniation (87%), LDD (100%), annular tear (100%), HIZ (61%), and end plate changes (4.4%). The findings of disc herniation, annular tear, HIZ, and LDD were more prevalent in A group than in B group (p<0.01). HIZ findings were more prevalent in A group than in group B or group C (p<0.05).
CONCLUSION
Patients with acute severe axial LBP were more likely to have disc herniation, LDD, annular tear, HIZ. Among LBP groups, there was a significant association of HIZ on MRI with acute severe axial LBP.

Keyword

Low back pain; Magnetic resonance imaging

MeSH Terms

Accidents, Traffic
Adult
Back Pain
Humans
Intervertebral Disc Degeneration
Low Back Pain
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets

Figure

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  Fig. 1 Magnetic resonance images of high intensity zone (HIZ), (A) The sagittal T2-weighted magnetic resonance image showing a HIZ (arrow) within the posterior annulus at L5-S1, (B) The axial T2-weighted magnetic resonance image shows a HIZ (arrow) within the posterior annulus at L5-S1.

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  Fig. 2 Magnetic resonance images of lumbar disc degeneration (LDD). The sagittal T2-weighted magnetic resonance image at L3-L4 and L4-L5 levels shows a degenerative signal loss with mild height reduction (arrows).

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  Fig. 3 Magnetic resonance images of Modic change. Modic type I (arrows): hypointense on T1-weighted magnetic resonance image (A) and hyperintense on T2-weighted magnetic resonance image (B).

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  Fig. 4 Magnetic resonance images of Modic change. Modic type II (arrows): hyperintense on T1-weighted magnetic resonance image (A) and hyperintense on T2-weighted magnetic resonance image (B).

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