Associations Between Sum Scores or Combinations of MRI Findings in the Lumbar Spine and Low Back Pain-Related Outcomes: A Systematic Review

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-07-18 DOI:10.1002/ejp.70076

Line Dragsbæk, Tue Secher Jensen, Per Kjær, Mark Hancock, Stine Clausen, Rikke Krüger Jensen

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引用次数: 0

Abstract

Background and Objective

Research on lumbar MRI findings has mainly focused on single MRI findings and their association with low back pain (LBP). Some studies suggest that summing or combining MRI findings may show stronger associations with LBP than single findings. This systematic review investigates how sum scores and combinations of lumbar MRI findings are associated with LBP-related outcomes.

Methods

We searched Embase, PubMed, CINAHL, Scopus and SPORTDiscus for studies reporting cross-sectional associations between sum scores/combinations of MRI findings and LBP. Two reviewers independently performed screening, data extraction and risk-of-bias (RoB) assessment. Study characteristics, definitions of sum scores/combinations of MRI findings and associations between sum scores of MRI findings and LBP outcomes were extracted and synthesised.

Results

We identified 11,537 studies and included 49 with 37 different study populations. Twelve studies had low RoB. Thirty-one studies investigated sum scores of one specific MRI finding. Ten out of 16 studies investigating disc degeneration, two out of three investigating herniation and seven out of 10 investigating endplate-related changes reported stronger associations between increasing sum scores and LBP. Additionally, seven of nine studies reported the same for disc degeneration and LBP-related disability. Sixteen studies investigated a sum score of different MRI findings. Eight of 11 studies reported stronger associations between increasing findings and LBP, and five of eight found the same for LBP-related disability.

Conclusion

Most studies reported stronger associations between increasing sum scores of MRI findings and LBP. We recommend focusing on cumulative MRI findings when investigating the relationship with LBP outcomes.

Significance Statement

This review emphasises the relevance of assessing MRI findings as a sum rather than as individual findings in understanding the mechanisms of low back pain. The findings offer a foundation for future research, promoting a more standardised approach to the assessment of MRI findings and their clinical relevance.

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腰椎的Sum评分或MRI表现组合与腰痛相关结果之间的关联：一项系统综述

背景与目的腰椎MRI表现的研究主要集中在单一MRI表现及其与腰痛（LBP）的关系。一些研究表明，综合或综合MRI表现可能比单一表现显示与腰痛的相关性更强。本系统综述探讨了腰椎MRI结果的总和评分和组合与腰bp相关结果的关系。方法：我们检索Embase、PubMed、CINAHL、Scopus和SPORTDiscus，检索报道MRI结果总和评分/组合与腰痛之间横断面关联的研究。两名审稿人独立进行筛选、数据提取和风险偏倚（RoB）评估。提取并综合了研究特征、MRI表现总和评分的定义/组合以及MRI表现总和评分与腰痛结局之间的关联。结果：我们共纳入了11537项研究，其中49项涉及37个不同的研究人群。12项研究的罗伯值较低。31项研究调查了一个特定MRI发现的总得分。16项调查椎间盘退变的研究中有10项，3项调查突出的研究中有2项，10项调查终板相关改变的研究中有7项报告称，总分增加与腰痛之间存在更强的关联。此外，9项研究中有7项报告了椎间盘退变和lbp相关残疾的相同结果。16项研究调查了不同MRI结果的总得分。11项研究中有8项报告了体重增加与LBP之间的密切联系，8项研究中有5项发现了与LBP相关的残疾。结论大多数研究报道了MRI表现sum评分升高与腰痛之间的较强相关性。我们建议在研究与腰痛预后的关系时，关注累积MRI结果。本综述强调了在理解腰痛机制方面，将MRI检查结果作为一个整体而不是单个结果进行评估的相关性。该研究结果为未来的研究奠定了基础，促进了更标准化的方法来评估MRI结果及其临床相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.