Association between Severity of Low Back Pain (LBP) and Magnetic Resonance Imaging Pathologies in Patients with Acute LBP

Background and Objectives: Low Back Pain (LBP) is a common health problem that affects people worldwide, and about 15% of Iranians. It imposes high costs to societies and requires great attention. Magnetic Resonance Imaging (MRI) is considered a reliable and accurate diagnostic tool, however some studies have questioned the appropriateness of MRI in LBP. Thus, this study aimed to evaluate the relationship between the intensity of LBP and positive findings in MRI, in patients with acute LBP. Materials and Methods: A cross-sectional study was performed on all patients, who reported less than four weeks of LBP and were referred to the radiology center of Shafa-e-Yahyaeian hospital, ranged from March to July, 2014, to perform MRI. Data collected included demographics and pain characteristics, in addition to an Oswestry Disability Index questionnaire. MRI pathologies were distinguished by two spinal surgeons and one radiologist. Data was analyzed using the SPSS software. Results: A total of 200 patients were enrolled in this study with a mean age of 41.78 years. Nearly half (48%) of the studied patients had positive MRI findings on L4-L5, and NFS and disc bulging (42.5%, and 38%, respectively) were the most common pathologies, while 11.5% of patients had normal MRIs. The mean ODI was highest in patients with vertebral body fracture, and disc herniation and lowest in hemangioma. Conclusion: A noticeable percentage of patients demonstrated a high ODI score, but MRI findings were in significant association with age of patients, indicating that patients with acute LBP do not require MRI immediately. Using the ODI questionnaire can help us towards a better diagnostic approach.