• Richard Kasch, Julia Truthmann, Mark J Hancock, Christopher G Maher, Markus Otto, Christopher Nell, Niklas Reichwein, Robin Bülow, Jean-François Chenot, Andre Hofer, Georgi Wassilew, and Carsten Oliver Schmidt.
• Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany.
• Spine. 2022 Feb 1; 47 (3): 201211201-211.

Study DesignPopulation-based cohort study.ObjectiveWe examined associations between common lumbar degenerative changes observed on magnetic resonance imaging (MRI) and present or future low back pain (LBP).Summary Of Background DataThe association between lumbar MRI degenerative findings and LBP is unclear. Longitudinal studies are sparse.MethodsParticipants (n = 3369) from a population-based cohort study were imaged at study entry, with LBP status measured at baseline and 6-year follow-up. MRI scans were reported on for the presence of a range of MRI findings. LBP status was measured on a 0 to 10 scale. Regression models were used to estimate the cross-sectional and longitudinal associations between individual and multiple MRI findings and LBP severity. Separate longitudinal analyses were conducted for participants with and without baseline pain.ResultsMRI findings were present in persons with and without back pain at baseline. Higher proportions were found in older age groups. 76.4% of participants had a least one MRI finding and 8.3% had five or more different MRI findings. Cross-sectionally, most MRI findings were slightly more common in those with LBP and pain severity was slightly higher in those with MRI findings (ranging from 0.06 for high intensity zone to 0.83 for spondylolisthesis). In the longitudinal analyses, we found most MRI findings were not associated with future LBP-severity regardless of the presence or absence of baseline pain. Compared to zero MRI findings, having multiple MRI findings (five or more) was associated with mildly greater pain-severity at baseline (0.84; 0.50-1.17) and greater increase in pain-severity over 6 years in those pain free at baseline (1.21; 0.04-2.37), but not in those with baseline pain (-0.30; -0.99 to 0.38).ConclusionOur study shows that the MRI degenerative findings we examined, individually or in combination, do not have clinically important associations with LBP, with almost all effects less than one unit on a 0 to 10 pain scale.Level of Evidence: 3.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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