Association of Modic Changes, Schmorl's Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults
A cross-sectional magnetic resonance imaging (MRI) study. We investigated the association among Modic changes, Schmorl's nodes, spondylolytic defects, high-intensity zone lesions, radial tears, herniations, and low back symptom severity. Disc degeneration is associated with low back pain in ear...
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| Veröffentlicht in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2012-06, Vol.37 (14), p.1231-1239 |
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| creator | TAKATALO, Jani KARPPINEN, Jaro NIINIMÄKI, Jaakko TAIMELA, Simo MUTANEN, Pertti BLANCO SEQUEIROS, Roberto NÄYHÄ, Simo JÄRVELIN, Marjo-Riitta KYLLÖNEN, Eero TERVONEN, Osmo |
| description | A cross-sectional magnetic resonance imaging (MRI) study.
We investigated the association among Modic changes, Schmorl's nodes, spondylolytic defects, high-intensity zone lesions, radial tears, herniations, and low back symptom severity.
Disc degeneration is associated with low back pain in early adulthood, but the associations between other MRI findings and low back pain are not well known.
Questionnaire data and MRI scans (1.5-T) were available for 554 subjects derived from a birth cohort at 21 years of age. Data on low back pain and back-related functional limitations at 18, 19, and 21 years of age were used for clustering of subjects, using latent class analysis. We used logistic regression with adjustment for the degree of disc degeneration to evaluate the associations between specific imaging findings and low back symptom severity.
The prevalence of herniations was 20%, Schmorl's nodes 17%, radial tears 9.9%, high-intensity zone lesions 3.2%, spondylolytic defects 5.8%, and Modic changes 0.7%. Latent class analysis produced 5 clusters: "Always Painful" (n = 65) meant painful at all time points and "Recent Onset Pain" (n = 56) meant increasing symptom severity, whereas subjects in the "Moderately Painful" (n = 73), "Minor Pain" (n = 193), and "No Pain" (n = 167) clusters had fewer symptoms. Compared with the "No Pain" cluster, Schmorl's nodes were more likely to occur in the "Always Painful" cluster (P = 0.017) and herniations in the 3 most painful clusters (P < 0.001). Herniations were associated with low back symptom severity (odds ratio, 2.5; 95% confidence interval, 1.4-4.4). Schmorl's nodes and radial tears were associated with symptoms in crude analyses only, whereas high-intensity zone lesions and spondylolytic defects occurred in similar frequencies in all clusters.
Herniations were most likely in the subjects with recent onset or persistent (3-yr period) low back symptoms, although they were also detected in subjects with no symptoms. The clinical relevance of herniations on MRI remains to be evaluated in the context of symptoms. |
| doi_str_mv | 10.1097/BRS.0b013e3182443855 |
| format | Article |
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We investigated the association among Modic changes, Schmorl's nodes, spondylolytic defects, high-intensity zone lesions, radial tears, herniations, and low back symptom severity.
Disc degeneration is associated with low back pain in early adulthood, but the associations between other MRI findings and low back pain are not well known.
Questionnaire data and MRI scans (1.5-T) were available for 554 subjects derived from a birth cohort at 21 years of age. Data on low back pain and back-related functional limitations at 18, 19, and 21 years of age were used for clustering of subjects, using latent class analysis. We used logistic regression with adjustment for the degree of disc degeneration to evaluate the associations between specific imaging findings and low back symptom severity.
The prevalence of herniations was 20%, Schmorl's nodes 17%, radial tears 9.9%, high-intensity zone lesions 3.2%, spondylolytic defects 5.8%, and Modic changes 0.7%. Latent class analysis produced 5 clusters: "Always Painful" (n = 65) meant painful at all time points and "Recent Onset Pain" (n = 56) meant increasing symptom severity, whereas subjects in the "Moderately Painful" (n = 73), "Minor Pain" (n = 193), and "No Pain" (n = 167) clusters had fewer symptoms. Compared with the "No Pain" cluster, Schmorl's nodes were more likely to occur in the "Always Painful" cluster (P = 0.017) and herniations in the 3 most painful clusters (P < 0.001). Herniations were associated with low back symptom severity (odds ratio, 2.5; 95% confidence interval, 1.4-4.4). Schmorl's nodes and radial tears were associated with symptoms in crude analyses only, whereas high-intensity zone lesions and spondylolytic defects occurred in similar frequencies in all clusters.
Herniations were most likely in the subjects with recent onset or persistent (3-yr period) low back symptoms, although they were also detected in subjects with no symptoms. The clinical relevance of herniations on MRI remains to be evaluated in the context of symptoms.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0b013e3182443855</identifier><identifier>PMID: 22166927</identifier><identifier>CODEN: SPINDD</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Biological and medical sciences ; Cerebrospinal fluid. Meninges. Spinal cord ; Cohort Studies ; Cross-Sectional Studies ; Diseases of the osteoarticular system ; Diseases of the spine ; Finland ; Geography ; Humans ; Intervertebral Disc Degeneration - complications ; Intervertebral Disc Degeneration - diagnosis ; Intervertebral Disc Displacement - diagnosis ; Intervertebral Disc Displacement - etiology ; Low Back Pain - diagnosis ; Low Back Pain - etiology ; Magnetic Resonance Imaging - methods ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Pain Measurement ; Radiography ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; Spine - diagnostic imaging ; Spondylolysis - diagnosis ; Spondylolysis - etiology ; Surveys and Questionnaires ; Young Adult</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2012-06, Vol.37 (14), p.1231-1239</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c557t-c1a3119394e61593b7d0b49cdcfcc240e3c3b3aa44398da2e7a63a75a42667fd3</citedby><cites>FETCH-LOGICAL-c557t-c1a3119394e61593b7d0b49cdcfcc240e3c3b3aa44398da2e7a63a75a42667fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26003656$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22166927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TAKATALO, Jani</creatorcontrib><creatorcontrib>KARPPINEN, Jaro</creatorcontrib><creatorcontrib>NIINIMÄKI, Jaakko</creatorcontrib><creatorcontrib>TAIMELA, Simo</creatorcontrib><creatorcontrib>MUTANEN, Pertti</creatorcontrib><creatorcontrib>BLANCO SEQUEIROS, Roberto</creatorcontrib><creatorcontrib>NÄYHÄ, Simo</creatorcontrib><creatorcontrib>JÄRVELIN, Marjo-Riitta</creatorcontrib><creatorcontrib>KYLLÖNEN, Eero</creatorcontrib><creatorcontrib>TERVONEN, Osmo</creatorcontrib><title>Association of Modic Changes, Schmorl's Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>A cross-sectional magnetic resonance imaging (MRI) study.
We investigated the association among Modic changes, Schmorl's nodes, spondylolytic defects, high-intensity zone lesions, radial tears, herniations, and low back symptom severity.
Disc degeneration is associated with low back pain in early adulthood, but the associations between other MRI findings and low back pain are not well known.
Questionnaire data and MRI scans (1.5-T) were available for 554 subjects derived from a birth cohort at 21 years of age. Data on low back pain and back-related functional limitations at 18, 19, and 21 years of age were used for clustering of subjects, using latent class analysis. We used logistic regression with adjustment for the degree of disc degeneration to evaluate the associations between specific imaging findings and low back symptom severity.
The prevalence of herniations was 20%, Schmorl's nodes 17%, radial tears 9.9%, high-intensity zone lesions 3.2%, spondylolytic defects 5.8%, and Modic changes 0.7%. Latent class analysis produced 5 clusters: "Always Painful" (n = 65) meant painful at all time points and "Recent Onset Pain" (n = 56) meant increasing symptom severity, whereas subjects in the "Moderately Painful" (n = 73), "Minor Pain" (n = 193), and "No Pain" (n = 167) clusters had fewer symptoms. Compared with the "No Pain" cluster, Schmorl's nodes were more likely to occur in the "Always Painful" cluster (P = 0.017) and herniations in the 3 most painful clusters (P < 0.001). Herniations were associated with low back symptom severity (odds ratio, 2.5; 95% confidence interval, 1.4-4.4). Schmorl's nodes and radial tears were associated with symptoms in crude analyses only, whereas high-intensity zone lesions and spondylolytic defects occurred in similar frequencies in all clusters.
Herniations were most likely in the subjects with recent onset or persistent (3-yr period) low back symptoms, although they were also detected in subjects with no symptoms. The clinical relevance of herniations on MRI remains to be evaluated in the context of symptoms.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Cohort Studies</subject><subject>Cross-Sectional Studies</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the spine</subject><subject>Finland</subject><subject>Geography</subject><subject>Humans</subject><subject>Intervertebral Disc Degeneration - complications</subject><subject>Intervertebral Disc Degeneration - diagnosis</subject><subject>Intervertebral Disc Displacement - diagnosis</subject><subject>Intervertebral Disc Displacement - etiology</subject><subject>Low Back Pain - diagnosis</subject><subject>Low Back Pain - etiology</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pain Measurement</subject><subject>Radiography</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Spine - diagnostic imaging</subject><subject>Spondylolysis - diagnosis</subject><subject>Spondylolysis - etiology</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd1u1DAQhS0EokvhDRDyDSoXpPgncZLL7ZaylRaQukUIbiLHnmwMib3YDihPx6vhsgtI3MxIx9-ckecg9JSSc0rq8tXFzfactIRy4LRiec6roriHFrRgVUZpUd9HC8IFy1jOxQl6FMIXQojgtH6IThijQtSsXKCfyxCcMjIaZ7Hr8FunjcKrXtodhJd4q_rR-eEs4HdO_xb2zup5cMMcE3cJHaiY5LXZ9dm1jWCDiTP-7CzgDYRkmh4vTVB4Dd4e1iRFWo1vpDZywLcgfcAfTezxxv3AF1J9xdt53Ec34i18B3_ntxyd3eFPbkr1ylhrQo-XehpieIwedHII8OTYT9GHq9e3q3W2ef_merXcZKooypgpKjmlNa9zEOk2vC01afNaadUpxXICXPGWS5nOWFdaMiil4LIsZM6EKDvNT9GLg-_eu28ThNiM6VcwDNKCm0JDCee0KKuSJTQ_oMq7EDx0zd6bUfo5Qc1ddE2Krvk_ujT27LhhakfQf4f-ZJWA50dABiWHzkurTPjHCZLyLgT_BaUapBQ</recordid><startdate>20120615</startdate><enddate>20120615</enddate><creator>TAKATALO, Jani</creator><creator>KARPPINEN, Jaro</creator><creator>NIINIMÄKI, Jaakko</creator><creator>TAIMELA, Simo</creator><creator>MUTANEN, Pertti</creator><creator>BLANCO SEQUEIROS, Roberto</creator><creator>NÄYHÄ, Simo</creator><creator>JÄRVELIN, Marjo-Riitta</creator><creator>KYLLÖNEN, Eero</creator><creator>TERVONEN, Osmo</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120615</creationdate><title>Association of Modic Changes, Schmorl's Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults</title><author>TAKATALO, Jani ; KARPPINEN, Jaro ; NIINIMÄKI, Jaakko ; TAIMELA, Simo ; MUTANEN, Pertti ; BLANCO SEQUEIROS, Roberto ; NÄYHÄ, Simo ; JÄRVELIN, Marjo-Riitta ; KYLLÖNEN, Eero ; TERVONEN, Osmo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c557t-c1a3119394e61593b7d0b49cdcfcc240e3c3b3aa44398da2e7a63a75a42667fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Cohort Studies</topic><topic>Cross-Sectional Studies</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the spine</topic><topic>Finland</topic><topic>Geography</topic><topic>Humans</topic><topic>Intervertebral Disc Degeneration - complications</topic><topic>Intervertebral Disc Degeneration - diagnosis</topic><topic>Intervertebral Disc Displacement - diagnosis</topic><topic>Intervertebral Disc Displacement - etiology</topic><topic>Low Back Pain - diagnosis</topic><topic>Low Back Pain - etiology</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pain Measurement</topic><topic>Radiography</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Spine - diagnostic imaging</topic><topic>Spondylolysis - diagnosis</topic><topic>Spondylolysis - etiology</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TAKATALO, Jani</creatorcontrib><creatorcontrib>KARPPINEN, Jaro</creatorcontrib><creatorcontrib>NIINIMÄKI, Jaakko</creatorcontrib><creatorcontrib>TAIMELA, Simo</creatorcontrib><creatorcontrib>MUTANEN, Pertti</creatorcontrib><creatorcontrib>BLANCO SEQUEIROS, Roberto</creatorcontrib><creatorcontrib>NÄYHÄ, Simo</creatorcontrib><creatorcontrib>JÄRVELIN, Marjo-Riitta</creatorcontrib><creatorcontrib>KYLLÖNEN, Eero</creatorcontrib><creatorcontrib>TERVONEN, Osmo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TAKATALO, Jani</au><au>KARPPINEN, Jaro</au><au>NIINIMÄKI, Jaakko</au><au>TAIMELA, Simo</au><au>MUTANEN, Pertti</au><au>BLANCO SEQUEIROS, Roberto</au><au>NÄYHÄ, Simo</au><au>JÄRVELIN, Marjo-Riitta</au><au>KYLLÖNEN, Eero</au><au>TERVONEN, Osmo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Modic Changes, Schmorl's Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2012-06-15</date><risdate>2012</risdate><volume>37</volume><issue>14</issue><spage>1231</spage><epage>1239</epage><pages>1231-1239</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><coden>SPINDD</coden><abstract>A cross-sectional magnetic resonance imaging (MRI) study.
We investigated the association among Modic changes, Schmorl's nodes, spondylolytic defects, high-intensity zone lesions, radial tears, herniations, and low back symptom severity.
Disc degeneration is associated with low back pain in early adulthood, but the associations between other MRI findings and low back pain are not well known.
Questionnaire data and MRI scans (1.5-T) were available for 554 subjects derived from a birth cohort at 21 years of age. Data on low back pain and back-related functional limitations at 18, 19, and 21 years of age were used for clustering of subjects, using latent class analysis. We used logistic regression with adjustment for the degree of disc degeneration to evaluate the associations between specific imaging findings and low back symptom severity.
The prevalence of herniations was 20%, Schmorl's nodes 17%, radial tears 9.9%, high-intensity zone lesions 3.2%, spondylolytic defects 5.8%, and Modic changes 0.7%. Latent class analysis produced 5 clusters: "Always Painful" (n = 65) meant painful at all time points and "Recent Onset Pain" (n = 56) meant increasing symptom severity, whereas subjects in the "Moderately Painful" (n = 73), "Minor Pain" (n = 193), and "No Pain" (n = 167) clusters had fewer symptoms. Compared with the "No Pain" cluster, Schmorl's nodes were more likely to occur in the "Always Painful" cluster (P = 0.017) and herniations in the 3 most painful clusters (P < 0.001). Herniations were associated with low back symptom severity (odds ratio, 2.5; 95% confidence interval, 1.4-4.4). Schmorl's nodes and radial tears were associated with symptoms in crude analyses only, whereas high-intensity zone lesions and spondylolytic defects occurred in similar frequencies in all clusters.
Herniations were most likely in the subjects with recent onset or persistent (3-yr period) low back symptoms, although they were also detected in subjects with no symptoms. The clinical relevance of herniations on MRI remains to be evaluated in the context of symptoms.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22166927</pmid><doi>10.1097/BRS.0b013e3182443855</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0362-2436 |
| ispartof | Spine (Philadelphia, Pa. 1976), 2012-06, Vol.37 (14), p.1231-1239 |
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| language | eng |
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| subjects | Adolescent Biological and medical sciences Cerebrospinal fluid. Meninges. Spinal cord Cohort Studies Cross-Sectional Studies Diseases of the osteoarticular system Diseases of the spine Finland Geography Humans Intervertebral Disc Degeneration - complications Intervertebral Disc Degeneration - diagnosis Intervertebral Disc Displacement - diagnosis Intervertebral Disc Displacement - etiology Low Back Pain - diagnosis Low Back Pain - etiology Magnetic Resonance Imaging - methods Medical sciences Nervous system (semeiology, syndromes) Neurology Pain Measurement Radiography Reproducibility of Results Sensitivity and Specificity Severity of Illness Index Spine - diagnostic imaging Spondylolysis - diagnosis Spondylolysis - etiology Surveys and Questionnaires Young Adult |
| title | Association of Modic Changes, Schmorl's Nodes, Spondylolytic Defects, High-Intensity Zone Lesions, Disc Herniations, and Radial Tears With Low Back Symptom Severity Among Young Finnish Adults |
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