TY - JOUR

T1 - Lumbar MRI and Back Pain After Failed Conservative Treatment

T2 - The RuDDS Study

AU - Leonova, Olga

AU - Elgaeva, Elizaveta

AU - Berdnikova, Anna

AU - Tsepilov, Yakov

AU - Krutko, Aleksandr

N1 - The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Russian Science Foundation (grant #22-15-20037) and Government of the Novosibirsk region.

PY - 2025

Y1 - 2025

N2 - Study DesignProspective disease-oriented study.ObjectiveTo describe the MRI findings in patients with failed conservative treatment for degenerative lumbar diseases and to identify predictors of back pain intensity in these patients.MethodsWe analyzed demographic (sex, age) and clinical scale data as well as the lumbar MRI findings (Pfirrmann disc degeneration, Modic types, endplate defects, disc height and osteophytes) in RuDDS patients. We examined the prevalence of degenerative changes in different age groups and searched for predictors of back pain intensity after the procedure in patients with specific leading syndromes.ResultsPatients with failed conservative treatment demonstrate more severe degeneration of the discs and endplates, more Modic changes, and higher Jarosz scores than reported in population-based studies. Individuals with degenerative stenosis have the most severe lumbar spine degeneration compared to patients with other leading syndromes (facet joint pain, lumbar disc herniation, degenerative deformity) (P < 0.004). Lumbar MRI findings had a weak (β < 0.1) though statistically significant effect on back pain intensity before the procedure and clinically significant back pain attenuation after it. Smoking had a greater impact on back pain and its attenuation after the procedure, especially in patients with degenerative stenosis (β = 0.307 and OR = 2.03, respectively).ConclusionThis is the first characterization of MRI findings in patients with failed conservative treatment. Smokers show more prominent back pain attenuation after the procedure than non-smokers; however it is not clear whether this treatment effect is sufficient.The trial registry number is NCT04600544 on clinicaltrials.gov.

AB - Study DesignProspective disease-oriented study.ObjectiveTo describe the MRI findings in patients with failed conservative treatment for degenerative lumbar diseases and to identify predictors of back pain intensity in these patients.MethodsWe analyzed demographic (sex, age) and clinical scale data as well as the lumbar MRI findings (Pfirrmann disc degeneration, Modic types, endplate defects, disc height and osteophytes) in RuDDS patients. We examined the prevalence of degenerative changes in different age groups and searched for predictors of back pain intensity after the procedure in patients with specific leading syndromes.ResultsPatients with failed conservative treatment demonstrate more severe degeneration of the discs and endplates, more Modic changes, and higher Jarosz scores than reported in population-based studies. Individuals with degenerative stenosis have the most severe lumbar spine degeneration compared to patients with other leading syndromes (facet joint pain, lumbar disc herniation, degenerative deformity) (P < 0.004). Lumbar MRI findings had a weak (β < 0.1) though statistically significant effect on back pain intensity before the procedure and clinically significant back pain attenuation after it. Smoking had a greater impact on back pain and its attenuation after the procedure, especially in patients with degenerative stenosis (β = 0.307 and OR = 2.03, respectively).ConclusionThis is the first characterization of MRI findings in patients with failed conservative treatment. Smokers show more prominent back pain attenuation after the procedure than non-smokers; however it is not clear whether this treatment effect is sufficient.The trial registry number is NCT04600544 on clinicaltrials.gov.

KW - MRI findings

KW - degenerated disc

KW - disease-oriented

KW - failed conservative treatment

KW - low back pain

UR - https://pubmed.ncbi.nlm.nih.gov/40901806/

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=105016871143&origin=inward

UR - https://www.mendeley.com/catalogue/88f5baa7-1642-348d-8cb9-a88a2ff4a1e4/

U2 - 10.1177/21925682251373046

DO - 10.1177/21925682251373046

M3 - Article

C2 - 40901806

SP - 21925682251373046

JO - Global spine journal

JF - Global spine journal

SN - 2192-5682

ER -